FDA Adverse Event Malfunction Summary report: N

1.6MM COMPRESSION WIRE

MDR report key: 2061394 · Received March 18, 2011

Report

Report Number
1719045-2011-00122
Event Type
Malfunction
Date Received
March 18, 2011
Date of Event
March 7, 2011
Report Date
March 7, 2011
Manufacturer
SYNTHES MONUMENT
Product Code
HWC
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INFORMATION WAS NOT PROVIDED DURING THE INITIAL REPORT. ADDITIONAL INFORMATION HAS BEEN REQUESTED. PRODUCT WAS NOT IMPLANTED AND/OR EXPLANTED. THE INVESTIGATION COULD NOT BE COMPLETED, NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RETURNED. A DEVICE HISTORY RECORD REVIEW HAS BEEN REQUESTED.

Description of Event or Problem · 1

DURING A PLATE AND SCREW PROCEDURE THE SURGEON WAS INSERTING A COMPRESSION WIRE INTO THE TWO HOLE STRAIGHT PLATE AND THE WIRE BROKE. SURGEON COULD NOT REMOVE 30 MM OF THE WIRE. SURGEON SHIFTED THE PLATE INSERTED ANOTHER WIRE AND COMPLETED THE INSERTION OF THE PLATE. AS THE SURGEON WAS REMOVING THE SECOND WIRE IT BROKE, LEAVING 30 MM OF WIRE IN THE PATIENT. SURGEON COULD NOT REMOVE THE TWO WIRES, 30 MM EACH WIRE REMAINS IN THE PATIENT. THIS IS TWO OF TWO REPORTS FOR THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 1.6MM COMPRESSION WIRE COMPRESSION WIRE HWC SYNTHES MONUMENT NA 3561120

Patients

Seq Age Sex Outcome Treatment
1 60 YR PLATE