FDA Adverse Event Injury Summary report: N

RECOPL 3.5 STRAIGHT 8HO L94 TI

MDR report key: 2211315 · Received August 3, 2011

Report

Report Number
8030965-2011-00527
Event Type
Injury
Date Received
August 3, 2011
Date of Event
June 10, 2011
Report Date
July 8, 2011
Manufacturer
SYNTHES GMBH
Product Code
HRS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT SVC. THE INVESTIGATION COULD NOT BE COMPLETED, NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RETURNED.

Description of Event or Problem · 1

REC'D DEVICE REPORT FROM SYNTHES GMBH. PT IMPLANTED WITH A 3.5MM RECONSTRUCTION PLATE ON (B)(6) 2011 FOR A RADIAL DIAPHYSEAL REGION FRACTURE. PT COMPLAINED OF PAIN AND SURGEON FOUND PLATE TO BE BROKEN. REVISION PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RECOPL 3.5 STRAIGHT 8HO L94 TI RECOPL 3.5 STRAIGHT 8HO HRS SYNTHES GMBH 2179094

Patients

Seq Age Sex Outcome Treatment
1 27 YR SCREW