FDA Adverse Event Malfunction Summary report: N

VOLAR SMARTLOCK DISTAL RADIUS PLATE, NARROW, RIGHT

MDR report key: 2481347 · Received March 5, 2012

Report

Report Number
8010177-2012-00048
Event Type
Malfunction
Date Received
March 5, 2012
Date of Event
December 30, 2011
Report Date
February 9, 2012
Manufacturer
STRYKER OSTEOSYNTHESIS FREIBURG
Product Code
HRS
PMA / PMN Number
K040022
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED FOR EVAL. INTERNAL INVESTIGATION BASED ON THE AVAILABLE INFO IN PROGRESS.

Description of Event or Problem · 1

ON (B)(6) 2011, A VARIAXDR OPERATION WAS PERFORMED. THE PT WAS ADMITTED TO THE HOSPITAL ON SUSPICION OF RUPTURE OF THE FPL. ON (B)(6) 2012, RECONSTRUCTION OF THE FPL WAS PERFORMED AFTER THE EXTRACTION OF VARIAXDR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VOLAR SMARTLOCK DISTAL RADIUS PLATE, NARROW, RIGHT IMPLANT HRS STRYKER OSTEOSYNTHESIS FREIBURG NA LC201SD117

Patients

Seq Age Sex Outcome Treatment
1 75 YR