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