FDA Adverse Event Malfunction Summary report: N

MANDIBULAR FRACTURE PLATE, 14-HOLES

MDR report key: 2240943 · Received August 17, 2011

Report

Report Number
8010177-2011-00245
Event Type
Malfunction
Date Received
August 17, 2011
Date of Event
May 17, 2011
Report Date
July 26, 2011
Manufacturer
STRYKER OSTEOSYNTHESIS FREIBURG
Product Code
JEY
PMA / PMN Number
K014263
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT WAS NOT RETURNED AND THUS DEEPER INVESTIGATIONS COULD NOT BE PERFORMED. THE ACTUAL ROOT CAUSE OF THE REPORTED EVENT COULD NOT BE DETERMINED. THE MOST LIKELY ROOT CAUSE OF THE FAILURE CAN BE ATTRIBUTED TO DYNAMIC OVERLOAD ON THE PLATE. BASED ON STATISTICAL EVALS, INDICATIONS FOR ANY DEVICE RELATED ISSUES WERE NOT FOUND.

Description of Event or Problem · 1

DOCTOR PUT IN A 14 HOLE FRACTURE PLATE ON (B)(6) AND IT SNAPPED IN PATIENTS MOUTH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MANDIBULAR FRACTURE PLATE, 14-HOLES IMPLANT JEY STRYKER OSTEOSYNTHESIS FREIBURG NA NA

Patients

Seq Age Sex Outcome Treatment
1 UNK