FDA Adverse Event Malfunction Summary report: N

3.5MM TI TRANSVERSE BAR

MDR report key: 2976854 · Received February 19, 2013

Report

Report Number
2530088-2013-10031
Event Type
Malfunction
Date Received
February 19, 2013
Date of Event
January 25, 2010
Report Date
January 25, 2010
Manufacturer
SYNTHES BRANDYWINE
Product Code
KWP
PMA / PMN Number
K091689
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SYNTHES IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO FDA WARNING LETTER DATED FEBRUARY 2012. ANY ADD'L INFO RECEIVED REGARDING THIS EVENT AFTER FILING THIS REPORT SHALL BE FILED ON A SUPPLEMENTAL MDR. THE ORIGINAL LOT NUMBER, 6185722, WAS U.S. LOT # RECEIVED ONCE DEVICE WAS REPACKAGED AT (B)(4) IS 3233268. DEVICE RECEIVED IN (B)(4) 2010, NOT AVAILABLE AT THIS TIME. A REVIEW OF THE MFG RECORD HAS BEEN REQUESTED.

Description of Event or Problem · 1

(B)(4) OF SYNTHES (B)(4) INFORMED SYNTHES PRODUCT SERVICE, (B)(4), THAT MULTIPLE UNOPENED TRANSVERSE BARS AND TRANSCONNECTORS WERE FOUND ON INCOMING INSPECTION TO HAVE THE SCREWS COMPLETELY SEPARATED FROM THE DEVICES INSIDE THE PACKAGES. THIS IS 7 OF 10 REPORTS FOR THE SAME EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
72810 3.5MM TI TRANSVERSE BAR KWP SYNTHES BRANDYWINE 3233268

Patients

Seq Age Sex Outcome Treatment
1