FDA Adverse Event Injury Summary report: N

TROCHANTERIC NAIL KIT, TI GAMMA3 10X170MM X 125

MDR report key: 2743257 · Received September 6, 2012

Report

Report Number
9610622-2012-00385
Event Type
Injury
Date Received
September 6, 2012
Date of Event
April 10, 2008
Report Date
August 9, 2012
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
HSB
PMA / PMN Number
K034223
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS DISCARDED. NO EVALUATION WILL BE PERFORMED. IF ADDITIONAL INFORMATION IS RECEIVED IT WILL BE REPORTED ON A SUPPLEMENTAL REPORT. ADDITIONAL DEVICES: 3060-0080S LAG SCREW, TI GAMMA3 10.5X80MM LOT# K472981; 1896-5035S LOCKING SCREW, FULLY THREADED T2 TIBIA 5X35 MM LOT# K492060.

Description of Event or Problem · 1

ON (B)(6) 2008, G3 OPERATION WAS PERFORMED. THREE DAYS AFTER THE OPERATION, THE PATIENT SUFFERED A FRACTURE AT THE PART OF NAIL'S END. THE PATIENT WAS REVISED TO A LONG NAIL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TROCHANTERIC NAIL KIT, TI GAMMA3 10X170MM X 125 IMPLANT HSB STRYKER OSTEOSYNTHESIS KIEL NA K459484

Patients

Seq Age Sex Outcome Treatment
1 88 YR Other| R