FDA Adverse Event Injury Summary report: N

TRIM-IT DRILL PIN, 1.5MM X 100MM

MDR report key: 2822261 · Received May 29, 2012

Report

Report Number
1220246-2012-00104
Event Type
Injury
Date Received
May 29, 2012
Date of Event
May 7, 2012
Report Date
December 1, 2011
Manufacturer
ARTHREX, INC.
Product Code
HTY
PMA / PMN Number
K050259
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

PT DEMOGRAPHICS (AGE AT TIME OF EVENT, DATE OF BIRTH, WEIGHT) WERE REQUESTED, BUT NOT PROVIDED. NO FURTHER PT INFO WAS PROVIDED AT THE TIME OF THIS REPORT OR MADE AVAILABLE IN RESPONSE TO F/U COMMUNICATION. NO ADDITIONAL ADVERSE CONSEQUENCES HAVE BEEN REPORTED FROM THIS EVENT. THIS DEVICE IS USED FOR TREATMENT. THE DEVICE WAS REQUESTED FOR EVAL, BUT WAS NOT RETURNED, THEREFORE THE COMPLAINANT'S EVENT COULD NOT BE VERIFIED. THE CAUSE OF THE EVENT COULD NOT BE DETERMINED FROM THE INFO AVAILABLE AND WITHOUT DEVICE EVAL. DEVICE HISTORY RECORD REVEALED NOTHING RELEVANT TO THIS EVENT. THE MOST LIKELY CAUSE OF THIS TYPE OF EVENT IS AN ADVERSE REACTION OF THE PT TO THE MATERIAL(S) IMPLANTED. PRODUCT DIRECTIONS FOR USE WARNS OF POSSIBLE FOREIGN BODY AND ALLERGIC-LIKE REACTIONS TO THE IMPLANT MATERIALS. PT SENSITIVITY TO DEVICE MATERIALS MUST BE CONSIDERED PRIOR TO IMPLANTATION. THIS IS THE FIRST COMPLAINT OF THIS TYPE FOR THIS PART/LOT COMBINATION. THE POTENTIAL CAUSE(S) OF THIS EVENT WILL BE COMMUNICATED TO THE EVENT REPORTER. IF ADDITIONAL RELEVANT INFO IS RECEIVED, A F/U REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT PT HAD A REACTION 6 MONTHS POST-OP AFTER HAMMER TOE SURGERY. A REACTION OF REDNESS, SWELLING AND A SKIN RASH STARTED TO DEVELOP. SURGEON REMOVED PIN ABOUT A MONTH AGO AND THE PT'S SYMPTOMS SEEM TO HAVE DISAPPEARED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRIM-IT DRILL PIN, 1.5MM X 100MM PIN, FIXATION, SMOOTH HTY ARTHREX, INC. 437850

Patients

Seq Age Sex Outcome Treatment
1 Other