FDA Adverse Event Injury Summary report: N

SMART TOE

MDR report key: 2588141 · Received May 8, 2012

Report

Report Number
3004082045-2012-00002
Event Type
Injury
Date Received
May 8, 2012
Date of Event
January 19, 2011
Report Date
January 19, 2011
Manufacturer
MEMOMETAL TECHNOLOGIES SA BRUZ
Product Code
KWH
PMA / PMN Number
K070598
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DEVICE IS NOT AVAILABLE FOR EVAL. ADD'L INFO WAS REQUESTED BUT NOT RECEIVED. IF THE DEVICE OR ADD'L INFO IS RECEIVED IT WILL BE REPORTED ON A SUPPLEMENTAL REPORT. AS INSTRUCTED BY (B)(6) ON (B)(6) 2011, MDR REPORTED BY MEMOMETAL TECHNOLOGIES/(B)(4) AS A RESULT OF A RETROSPECTIVE LOOK BACK OF COMPLAINTS RESULTING FROM THE ACQUISITION OF MEMOMETAL TECHNOLOGIES BY (B)(6).

Description of Event or Problem · 1

AFTER THE SURGERY, IMPLANT HAS BROKEN IN THE PT'S FOOT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SMART TOE IMPLANT KWH MEMOMETAL TECHNOLOGIES SA BRUZ NA 0006484Q18

Patients

Seq Age Sex Outcome Treatment
1 UNK Other