FDA Adverse Event Injury Summary report: N

HTR-PMI GRIMES RT FRT

MDR report key: 2461573 · Received February 20, 2012

Report

Report Number
0001032347-2012-00014
Event Type
Injury
Date Received
February 20, 2012
Report Date
February 13, 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
OK, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A VALID CONCLUSION ABOUT THE CAUSE OF THIS EVENT. IF ADDITIONAL INFORMATION IS OBTAINED THAT ADDS VALUE TO THE RELEVANT CONTENT OF THIS REPORT AND/OR A CONCLUSION CAN BE DRAWN, A FOLLOW-UP REPORT WILL BE SENT.

Description of Event or Problem · 1

THE PATIENT HAD A REVISION SURGERY WHERE THE HTR WAS REMOVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HTR-PMI GRIMES RT FRT HARD TISSUE REPLACEMENT KKY BIOMET MICROFIXATION N/A 070230

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization