FDA Adverse Event Injury Summary report: N

ASCENSION NUGRIP

MDR report key: 2030573 · Received March 18, 2011

Report

Report Number
1651501-2011-00009
Event Type
Injury
Date Received
March 18, 2011
Date of Event
August 12, 2010
Report Date
March 18, 2011
Manufacturer
ASCENSION ORTHOPEDICS, INC.
Product Code
KYI
PMA / PMN Number
K041451
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

X-RAYS WERE SUPPLIED, BUT WERE NOT CONCLUSIVE IN A CAUSE. IF ADD'L INFO IS OBTAINED, A SUPPLEMENTAL REPORT WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

THE SURGEON REPORTED THAT HE HAD TO REVISE A NUGRIP PROSTHESIS BECAUSE OF REOCCURRING PAIN AND STEM MIGRATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ASCENSION NUGRIP WRIST JOINT CARPAL TRAPEZIUM PROSTHESIS KYI ASCENSION ORTHOPEDICS, INC. THB-442-1010-WW

Patients

Seq Age Sex Outcome Treatment
1 54 YR Hospitalization| R