BEUDAMED
    FDA Adverse Event Other Summary report: N

    FULL-THREADED CANCELLOUS SCREW, 4.0 X 26 MM

    MDR report key: 28260 · Received November 27, 1995

    Report

    Report Number
    MW1007761
    Event Type
    Other
    Date Received
    November 27, 1995
    Date of Event
    November 9, 1995
    Report Date
    November 20, 1995
    Manufacturer
    SYNTHES USA
    Product Code
    HWC
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    SCREW SHAFT BROKE OFF IN LT ELBOW DURING SURGICAL PLACEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FULL-THREADED CANCELLOUS SCREW, 4.0 X 26 MM Implant SCREW HWC SYNTHES USA

    Patients

    Seq Age Sex Outcome Treatment
    1 20 YR Other