FDA Adverse Event Injury Summary report: N

TROCHANTERIC NAIL KIT, TI 10X170 MM X 125

MDR report key: 2012878 · Received March 1, 2011

Report

Report Number
9610622-2011-00095
Event Type
Injury
Date Received
March 1, 2011
Date of Event
January 6, 2011
Report Date
February 15, 2011
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
HSB
PMA / PMN Number
K034002
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NA

Description of Event or Problem · 1

ON 2008 (B)(6), THE PATIENT UNDERWENT SURGERY WITH A G3 TROCHANTERIC NAIL. ON (B)(6) 2010, THE PATIENT FELL AND THE DISTAL RADIUS WAS FRACTURED. IN (B)(6) 2010, THE PATIENT FELT PAIN IN HIP. THE SURGEON WAS MONITORING THE PATIENT. ON 2011 (B)(6), THE SURGEON CONFIRMED BY X-RAY THAT THE LAG SCREW HOLE ON THE NAIL WAS BROKEN. ON 2011 (B)(6), THE PATIENT WAS REVISED WITH A G3 LONG NAIL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TROCHANTERIC NAIL KIT, TI 10X170 MM X 125 IMPLANT HSB STRYKER OSTEOSYNTHESIS KIEL NA K706155

Patients

Seq Age Sex Outcome Treatment
1 81 YR Required Intervention