FDA Adverse Event Injury Summary report: N

2520274-2013-01407

MDR report key: 3001353 · Received March 13, 2013

Report

Report Number
2520274-2013-01407
Event Type
Injury
Date Received
March 13, 2013
Report Date
February 15, 2013
Manufacturer
SYNTHES USA
Product Code
HWC
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NV
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, 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

PATIENT WAS IMPLANTED WITH DISTAL HUMERUS PLATES, ULNA PLATE, AND SCREWS ON AN UNKNOWN DATE. PATIENT CONSENTED FOR REMOVAL OF HARDWARE DUE TO HARDWARE PROMINENCE IN THE LEFT ELBOW. PATIENT WAS RETURNED TO THE OR ON (B)(6) 2013 AND THE HARDWARE WAS REMOVED WITHOUT COMPLICATIONS. THIS REPORT IS FOR AN UNKNOWN 3.5MM CORTEX SCREW. THIS IS 17 OF 27 REPORTS FOR THE SAME EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
105074 HWC SYNTHES USA

Patients

Seq Age Sex Outcome Treatment
1 48 YR Required Intervention