FDA Adverse Event Injury Summary report: N

2520274-2013-02318

MDR report key: 3091368 · Received May 3, 2013

Report

Report Number
2520274-2013-02318
Event Type
Injury
Date Received
May 3, 2013
Report Date
April 5, 2013
Manufacturer
SYNTHES USA
Product Code
HSB
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
HEALTH PROFESSIONAL

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 COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. PLACEHOLDER.

Description of Event or Problem · 1

A PATIENT WAS IMPLANTED WITH A TROCHANTERIC FIX NAIL (TFN) AND 11.0MM HELICAL BLADE ON (B)(6)2013. ON AN UNKNOWN DATE, THE TFN CUT OUT OF THE FEMORAL HEAD ANTERIORLY. PATIENT DEVELOPED A HIP INFECTION ON AN UNKNOWN DATE. THIS WAS VERIFIED BY THE SURGEON ON (B)(6) 2013. PATIENT UNDERWENT REVISION SURGERY FOR REMOVAL OF HARDWARE ON (B)(6) 2013 AND WAS CONVERTED TO HEMIARTHROPLASTY. THE TITANIUM TFN, 11.0MM TITANIUM HELICAL BLADE, AND 5.0MM TITANIUM LOCKING SCREW WERE EXPLANTED. NO ADDITIONAL INFORMATION IS AVAILABLE. THIS REPORT IS FOR AN UNKNOWN HELICAL BLADE. THIS IS REPORT 3 OF 3 FOR COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
194293 HSB SYNTHES USA

Patients

Seq Age Sex Outcome Treatment
1 69 YR Required Intervention