FDA Adverse Event Injury Summary report: N

SCREW

MDR report key: 2831481 · Received November 14, 2012

Report

Report Number
2520274-2012-03116
Event Type
Injury
Date Received
November 14, 2012
Date of Event
October 17, 2012
Report Date
October 17, 2012
Product Code
HWC
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THIS DEVICE IS USED FOR TREATMENT NOT DIAGNOSIS.

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT. ADDITIONAL NARRATIVE: INVESTIGATION COULD NOT BE COMPLETED, NO CONCLUSION COULD BE DRAWN AS NO DEVICE WAS RETURNED AND NO PART OR LOT NUMBER WAS PROVIDED.

Description of Event or Problem · 1

A REPORT WAS RECEIVED REGARDING AN EXPLANT PROCEDURE TO REMOVE A FEMUR PLATE AND SCREWS; UNKNOWN REASON FOR THE EXPLANT. DURING THE PROCEDURE, THE SURGEON FOUND THAT TWO SCREWS WERE COLD-WELDED TO THE REVISING FEMUR PLATE. THE SURGEON USED CARBIDE DRILL BITS TO DRILL TO REMOVE THE SCREWS FROM THE PLATE. THE SCREWS AND PLATE WERE EXPLANTED WITH NO FRAGMENTS TO RETRIEVE. THE PLATE AND SCREWS WERE NOT BROKEN. THIS IS REPORT #2 OF 3 FOR THE SAME EVENT.

Description of Event or Problem · 1

PATIENT WAS REVISED DUE TO NON-UNION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SCREW SCREW HWC

Patients

Seq Age Sex Outcome Treatment
1 53 YR Required Intervention