FDA Adverse Event Injury Summary report: N

UNKNOWN GAMMA3 LAG SCREW

MDR report key: 2850815 · Received November 21, 2012

Report

Report Number
9610622-2012-00541
Event Type
Injury
Date Received
November 21, 2012
Date of Event
March 1, 2011
Report Date
November 14, 2012
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
HWC
PMA / PMN Number
UNK
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

DEVICE WILL NOT BE RETURNED. ONCE THE INVESTIGATION HAS BEEN COMPLETED ANY ADDITIONAL INFORMATION WILL BE REPORTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

THIS CASE WAS PRESENTED AT THE MEETING OF (B)(6) ON (B)(6) 2012. THE SURGEON USED THE G3 NAILS (292 CASE) FROM (B)(6) 2005 TO (B)(6) 2011. THE ONE OF 292 CASES, THE PATIENT FELT THE PAIN BY OVER TELESCOPING OF THE LAG SCREW. THEREFORE THE REVISION SURGERY WAS PERFORMED. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN GAMMA3 LAG SCREW IMPLANT HWC STRYKER OSTEOSYNTHESIS KIEL NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Other| R