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 |