FDA Adverse Event Injury Summary report: N

MMF SCREW

MDR report key: 3022746 · Received March 22, 2013

Report

Report Number
9610905-2013-00009
Event Type
Injury
Date Received
March 22, 2013
Date of Event
March 21, 2013
Report Date
March 21, 2013
Manufacturer
KARL LEIBINGER MEDIZINTECHNIK GMBH & CO. KG
Product Code
DZL
PMA / PMN Number
K042573
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS IS ONE OF TWO RELATED MDR'S. REFER TO 9610905-2013-00010.

Description of Event or Problem · 1

SURGEON WAS USING MMF SCREWS TO CONSOLIDATE FRACTURE. MMF SCREWS BROKE NEAR THE HEAD UPON REMOVAL. BOTTOM PORTION OF SCREWS WILL REMAIN IMPLANTED. PATIENT HEALTH WAS NOT COMPROMISED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
119192 MMF SCREW DZL KARL LEIBINGER MEDIZINTECHNIK GMBH & CO. KG 25-092-08

Patients

Seq Age Sex Outcome Treatment
1 45 YR Other