FDA Adverse Event Injury Summary report: N

SCREW LOCKING

MDR report key: 2926036 · Received January 23, 2013

Report

Report Number
2520274-2013-00540
Event Type
Injury
Date Received
January 23, 2013
Date of Event
August 19, 2012
Report Date
December 28, 2012
Manufacturer
SYNTHES (USA)
Product Code
HWC
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE USED FOR TREATMENT AND 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

A DEVICE REPORT FROM (B)(6) INDICATED A HOSPITAL IN (B)(6) REPORTED: DURING A PROCEDURE, A DISCONNECTION OF THE EXTRACTION ARM COULD NOT BE ACHIEVED. THE DISTRACTOR WAS EXPLANTED. NO FURTHER INFORMATION IS AVAILABLE. THIS IS 4 OF 4 REPORTS FOR THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
32466 SCREW LOCKING HWC SYNTHES (USA)

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention DISTRACT-BODY, MESH FOOT, LOCKING SCREW