FDA Adverse Event Injury Summary report: N

SCREW

MDR report key: 2872644 · Received December 7, 2012

Report

Report Number
2520274-2012-03661
Event Type
Injury
Date Received
December 7, 2012
Date of Event
November 9, 2012
Report Date
November 9, 2012
Manufacturer
SYNTHES USA
Product Code
DZL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
HEALTH PROFESSIONAL

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

PT WAS IMPLANTED WITH A LCP CURVED CONDYLAR PLATE AND SCREWS ON (B)(6) 2012. ON AN UNK DATE, PT HAD X-RAYS PERFORMED, REVEALING A PLATE THAT WAS BROKEN JUST SUPERIOR TO THE KNEE (DISTAL FEMUR). PT WAS RETURNED TO THE OPERATING ROOM ON (B)(6) 2012 FOR REMOVAL OF HARDWARE DUE TO NON-UNION AND BROKEN PLATE. THE SURGEON PERFORMED A REAMER/IRRIGATOR/ASPIRATOR (RIA) PROCEDURE, IMPLANTED A COMPETITORS RETROGRADE NAIL. THIS IS 2 OF 12 REPORTS FOR THIS EVENT. `

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SCREW DZL SYNTHES USA

Patients

Seq Age Sex Outcome Treatment
1 60 YR Required Intervention CONDYLAR PLATE X 1| SCREW X 10