FDA Adverse Event Injury Summary report: N

ORTHOLOC(TM) 3DSI CLAW(R) II PLATE

MDR report key: 3070509 · Received April 22, 2013

Report

Report Number
1043534-2013-00658
Event Type
Injury
Date Received
April 22, 2013
Date of Event
February 14, 2013
Report Date
March 6, 2013
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
HRS
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CONCLUSION: NO FAILURE DETECTED AND PRODUCT WITHIN SPECIFICATION.THE COMPLAINT WAS REVIEWED AND ANALYSIS SHOWED NO TREND FOR ITEM/LOT. X-RAYS WERE PROVIDED AND REVIEWED. PHOTOGRAPHIC IMAGES WERE MADE OF THE RETURNED PRODUCT.(B)(4).

Additional Manufacturer Narrative · 1

INVESTIGATION IS NOT COMPLETE. TRENDS WILL BE EVALUATED. THE EVENT CODE IS ADDRESSED IN THE PACKAGE INSERT. THIS REPORT WILL BE UPDATED WHEN THE INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

ALLEGEDLY BROKEN PLATE DUE TO NON-UNION. POSSIBLE INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
171713 ORTHOLOC(TM) 3DSI CLAW(R) II PLATE SMALL JOINT COMPONENT, CODE:HRS HRS WRIGHT MEDICAL TECHNOLOGY, INC. 1420432

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention