FDA Adverse Event Injury Summary report: N

KALIX II FLAT FOOT IMPLANT EXTERNAL DIAM. 11MM

MDR report key: 2166385 · Received May 22, 2007

Report

Report Number
9615741-2007-00027
Event Type
Injury
Date Received
May 22, 2007
Date of Event
April 17, 2007
Report Date
May 22, 2007
Manufacturer
NEWDEAL S.A.
Product Code
HWC
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED FOR EVAL. AN INVESTIGATION HAS BEEN INITIATED BASED UPON THE REPORTED INFO.

Description of Event or Problem · 1

THE DISTRIBUTOR REPORTED ON BEHALF OF THE USER FACILITY THE FOLLOWING INCIDENT: THE SURGERY, THE PHYSICIAN ATTEMPTED TO INSERT A KALIX II IMPLANT SIZE 11. THE IMPLANT DID NOT EXPAND. THE IMPLANT WAS REMOVED AND IS AVAILABLE FOR EVALUATION. A KALIX II IMPLANT SIZE 10 WAS USED TO COMPLETE THE PROCEDURE. NO PT INJURY OCCURRED. ADDITIONAL INFO HAS BEEN REQUESTED FROM THE USER FACILITY. THIS INCIDENT IS RELATED TO MDR# 9615741-2007-00026.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 KALIX II FLAT FOOT IMPLANT EXTERNAL DIAM. 11MM KALIX II SYSTEM HWC NEWDEAL S.A. E3FE

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention