FDA Adverse Event Malfunction Summary report: N

PFNA BLADE PERF L100 TAN

MDR report key: 2964215 · Received February 15, 2013

Report

Report Number
8030965-2013-00492
Event Type
Malfunction
Date Received
February 15, 2013
Report Date
January 21, 2013
Manufacturer
SYNTHES GMBH
Product Code
HSB
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE USED FOR TREATMENT AND NOT DIAGNOSIS. DEVICE IS NOT DISTRIBUTED IN THE UNITED STATES, BUT IS SIMILAR TO DEVICE MARKETED IN THE USA. MANUFACTURING DOCUMENTS WERE REVIEWED AND NO COMPLAINT RELATED ISSUES WERE FOUND. THE PFNA BLADE WAS ANALYZED FOR CONFORMANCE TO PRINT SPECIFICATIONS. THE REVIEW REVEALED THAT THE IMPLANT WAS MANUFACTURED IN AUGUST 2012 ACCORDING TO THE SPECIFICATIONS, NO ABNORMAL FINDINGS WERE IDENTIFIED. IN ADDITION THE IMPLANT WAS FOUND TO BE IN PERFECT WORKING ORDER, THE PFNA BLADE COULD BE LOOSENED USING SOME SLIGHTLY INCREASED TORQUE. UNFORTUNATELY THE EXACT CAUSE OF FAILURE COULD NOT BE DETERMINED; A POSSIBLE REASON MAY BE A WRONG ROTATING DIRECTION DURING THE ATTEMPT OF LOOSENING, LEFT HAND-THREAD.

Description of Event or Problem · 1

A DEVICE REPORT FROM (B)(4) INDICATES A HOSPITAL IN THE (B)(6) REPORTED: BLADE CANNOT BE LOOSENED. IT IS NOT POSSIBLE TO UNLOCK THE BLADE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
68366 PFNA BLADE PERF L100 TAN PFNA BLADE HSB SYNTHES GMBH 8027051

Patients

Seq Age Sex Outcome Treatment
1