FDA Adverse Event Injury Summary report: N

PALMAR RADIUS FRACTURE PLATE, LOCKING, MEDIUM, RIG

MDR report key: 2031398 · Received March 23, 2011

Report

Report Number
8010177-2011-00081
Event Type
Injury
Date Received
March 23, 2011
Date of Event
January 15, 2011
Report Date
February 28, 2011
Manufacturer
STRYKER OSTEOSYNTHESIS FRIEBURG
Product Code
HRS
PMA / PMN Number
K040022
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT YET RETURNED FOR ANALYSIS. INVESTIGATION IN PROCESS, BUT NOT YET COMPLETE.

Description of Event or Problem · 1

SURGEON REPORTED VIA OUR SALES REP THAT PLATE FAILED / BENT IN SECOND HOLE ROW. FURTHER THE SURGEON REPORTED THAT DURING PRIMARY SURGERY THE PLATE WAS FIXED IN THE FIRST HOLE ROW, SECOND ROW WAS NOT FIXED. ALSO SURGEON MENTIONED THAT THE PT SUFFERED FROM PAIN AND SURGEON RECOGNIZED THAT THE PLATE WAS BENT. THEREFORE, A REVISION SURGERY WAS PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PALMAR RADIUS FRACTURE PLATE, LOCKING, MEDIUM, RIG IMPLANT HRS STRYKER OSTEOSYNTHESIS FRIEBURG NA LCH00F1773

Patients

Seq Age Sex Outcome Treatment
1 78 YR Other