FDA Adverse Event Malfunction Summary report: N

PLATE

MDR report key: 2556698 · Received April 25, 2012

Report

Report Number
2520274-2012-00528
Event Type
Malfunction
Date Received
April 25, 2012
Report Date
March 4, 2012
Product Code
HRS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVENT REPORTED TO SYNTHES USA ON (B)(6) 2012, SYNTHES FIRST AWARENESS DATE WAS (B)(6) 2012. INVESTIGATION COULD NOT BE COMPLETED, NO CONCLUSION COULD BE DRAWN AS DEVICE WAS NOT EXPLANTED AND THEREFORE, NOT RETURNED, AND PART NUMBER AND LOT NUMBER WERE NOT PROVIDED. ADD'L INFO WAS REQUESTED TWO TIMES AND HAS NOT BEEN RECEIVED.

Description of Event or Problem · 1

DEVICE REPORT RECEIVED FROM (B)(6) REPORTED A SURGEON REVIEWED A POST-OPERATIVE X-RAY AND NOTED THE 3.5 MM. RECONSTRUCTION PLATE WAS BROKEN. PT WAS NOT REVISED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PLATE HRS

Patients

Seq Age Sex Outcome Treatment
1