FDA Adverse Event Injury Summary report: N

7.3MM CANNULATED SCREW 32MM THREAD/100MM

MDR report key: 2895868 · Received January 3, 2013

Report

Report Number
1719045-2013-00007
Event Type
Injury
Date Received
January 3, 2013
Report Date
December 5, 2012
Manufacturer
SYNTHES MONUMENT
Product Code
HWC
PMA / PMN Number
K962011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. 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

PATIENT WAS IMPLANTED WITH CANNULATED SCREWS ON (B)(6) 2011. ON AN UNKNOWN DATE, PATIENT COMPLAINED OF PAINFUL HARDWARE FROM AVASCULAR NECROSIS (AVN) OF THE LEFT FEMUR. PATIENT RETURNED TO THE OPERATING ROOM ON (B)(6) 2012 AND THE HARDWARE WAS REMOVED WITHOUT COMPLICATIONS. THIS IS 1 OF 3 REPORTS FOR THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
3641 7.3MM CANNULATED SCREW 32MM THREAD/100MM SCREW HWC SYNTHES MONUMENT

Patients

Seq Age Sex Outcome Treatment
1 88 YR Required Intervention SCREWS