FDA Adverse Event Injury Summary report: N

LONG NAIL KIT R2.0, TI, LEFT GAMMA3 ?11X400MM X 13

MDR report key: 2869976 · Received December 4, 2012

Report

Report Number
9610622-2012-00549
Event Type
Injury
Date Received
December 4, 2012
Date of Event
November 13, 2012
Report Date
November 13, 2012
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
HSB
PMA / PMN Number
K034002
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

DEVICE WILL NOT BE RETURNED. IF THE DEVICE OR ADDITIONAL INFORMATION BECOMES AVAILABLE IT WILL BE REPORTED ON A SUPPLEMENTAL REPORT. ADDITIONAL DEVICE 3060-0085S LAG SCREW, TI GAMMA3 - 10.5X85MM LOT# K894800.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT PRESENTED WITH NONUNION SO DOCTOR REMOVED GAMMA AND PROCEEDED TO DIFFERENT NAIL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LONG NAIL KIT R2.0, TI, LEFT GAMMA3 ?11X400MM X 13 IMPLANT HSB STRYKER OSTEOSYNTHESIS KIEL NA K525591

Patients

Seq Age Sex Outcome Treatment
1 91 YR Other| R