FDA Adverse Event Injury Summary report: N

LCP DISTTIBPL2.7/3.5 MED R SHAFT 8HO SST

MDR report key: 2822870 · Received November 7, 2012

Report

Report Number
2520274-2012-02992
Event Type
Injury
Date Received
November 7, 2012
Date of Event
December 6, 2008
Report Date
October 10, 2012
Manufacturer
SYNTHES USA
Product Code
HRS
PMA / PMN Number
K013248
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED.

Description of Event or Problem · 1

DEVICE REPORT FROM (B)(6) REPORTS AN EVENT IN (B)(6) AS FOLLOWS: PATIENT WAS IMPLANTED WITH PLATE ON (B)(6) 2007. THE PLATE BROKE POST-OPERATIVE. NO FURTHER INFORMATION IS AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LCP DISTTIBPL2.7/3.5 MED R SHAFT 8HO SST PLATE HRS SYNTHES USA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention