FDA Adverse Event Injury Summary report: N

LACTOSORB PECTUS STABILIZER

MDR report key: 2821920 · Received November 7, 2012

Report

Report Number
0001032347-2012-00159
Event Type
Injury
Date Received
November 7, 2012
Report Date
October 16, 2012
Manufacturer
BIOMET MICROFIXATION
Product Code
HRS
PMA / PMN Number
PN/A
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FI
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE USER FACILITY IS FOREIGN; THEREFORE, A FACILITY MEDWATCH REPORT WILL NOT BE AVAILABLE. 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 DISTRIBUTOR NOTIFIED OF A REVISION SURGERY THAT TOOK PLACE IN 2008.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LACTOSORB PECTUS STABILIZER PECTUS STABILIZER HRS BIOMET MICROFIXATION N/A UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization