FDA Adverse Event Injury Summary report: N

LCP VOLAR COLUMN DISTAL RADIUSPL 7H HEAD/4H SHAFT/LT

MDR report key: 2931115 · Received January 28, 2013

Report

Report Number
3003506883-2013-00041
Event Type
Injury
Date Received
January 28, 2013
Date of Event
November 15, 2012
Report Date
January 8, 2013
Manufacturer
SYNTHES ELMIRA
Product Code
HRS
PMA / PMN Number
K091644
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, 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. PLACEHOLDER.

Description of Event or Problem · 1

PATIENT SUFFERED A WRIST FRACTURE AND WAS IMPLANTED WITH PLATE AND SCREW CONSTRUCT ON (B)(6) 2012. ON (B)(6) 2012, PATIENT FELL AND RE-FRACTURED THE WRIST, BENDING THE PREVIOUSLY IMPLANTED PLATE. PATIENT RETURNED TO THE OPERATING ROOM ON (B)(6) 2013, FOR REMOVAL OF HARDWARE. PATIENT WAS REVISED WITH A LONGER PLATE. THIS IS 1 OF 8 REPORTS FOR THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
36970 LCP VOLAR COLUMN DISTAL RADIUSPL 7H HEAD/4H SHAFT/LT DISTAL RADIUS PLATE HRS SYNTHES ELMIRA

Patients

Seq Age Sex Outcome Treatment
1 39 YR Required Intervention