FDA Adverse Event
Injury
Summary report: N
3.5MM LCP OLECRANON PLATE 2 HOLES/LEFT/86MM
MDR report key: 2900333
·
Received January 7, 2013
Report
- Report Number
- 8030965-2013-00054
- Event Type
- Injury
- Date Received
- January 7, 2013
- Report Date
- December 12, 2012
- Manufacturer
- SYNTHES GMBH
- Product Code
- KTT
- PMA / PMN Number
- K000684
- 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. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. THE MANUFACTURING RECORDS WERE REVIEWED AND NO COMPLAINT RELATED ISSUES WERE FOUND.
Description of Event or Problem · 1
PATIENT WAS IMPLANTED WITH A 3.5MM LCP OLECRANON PLATE AND SCREW CONSTRUCT ON (B)(6) 2011. PATIENT RETURNED TO THE OR ON (B)(6) 2012. PATIENT GAVE CONSENT FOR REMOVAL OF HARDWARE FROM THE LEFT ELBOW DUE TO HARDWARE PROMINENCE. ALL HARDWARE WAS REMOVED WITHOUT COMPLICATIONS. PATIENT WAS NOT REVISED WITH ANY ADDITIONAL HARDWARE BECAUSE IT IS REPORTED THAT THE PATIENT WAS HEALED. THIS IS 1 OF 7 REPORTS FOR THIS EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 7407 | 3.5MM LCP OLECRANON PLATE 2 HOLES/LEFT/86MM | PLATE | KTT | SYNTHES GMBH | 3570615 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 31 YR | Required Intervention | SCREWS |