FDA Adverse Event Other Summary report: N

STABILIS PLATE TTC

MDR report key: 2428799 · Received December 29, 2011

Report

Report Number
3004983210-2011-00012
Event Type
Other
Date Received
December 29, 2011
Date of Event
August 24, 2011
Report Date
December 13, 2011
Manufacturer
TORNIER INC.
Product Code
HRS
PMA / PMN Number
K090139
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
ID, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

THIS IS THE FINAL REPORT SUBMITTED REGARDING THIS SURGICAL EVENT AND MEDICAL DEVICE. NO ADDITIONAL INFORMATION IS ANTICIPATED.

Description of Event or Problem · 1

ON (B)(6) 2011, PT WAS ADMITTED TO THE HOSPITAL TO UNDERGO A MULTISTAGE FIXATION SALVAGE PROCEDURE FOR HER LEFT ANKLE AFTER A FAILED TTC FUSION DUE TO INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STABILIS PLATE TTC NONE HRS TORNIER INC.

Patients

Seq Age Sex Outcome Treatment
1 69 YR