FDA Adverse Event Injury Summary report: N

HTR

MDR report key: 2429014 · Received January 26, 2012

Report

Report Number
0001032347-2012-00007
Event Type
Injury
Date Received
January 26, 2012
Report Date
January 20, 2012
Manufacturer
BIOMET MICROFIXATION
Product Code
KKY
PMA / PMN Number
PK924935
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DOCTOR WAS ABLE TO IMPLANT THE DEVICE, THE SURGERY WAS DELAY AS HE MODIFIED THE DEVICE SO THAT IT FIT THE PATIENT. REVIEW OF DEVICE HISTORY RECORDS SHOW THAT LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION.

Description of Event or Problem · 1

THE PATIENT HAD AN INFECTION FROM THE EPIDURAL AND THE HTR WAS EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HTR HARD TISSUE REPLACEMENT KKY BIOMET MICROFIXATION N/A 347770

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization