FDA Adverse Event Injury Summary report: N

2520274-2013-02462

MDR report key: 3101794 · Received May 9, 2013

Report

Report Number
2520274-2013-02462
Event Type
Injury
Date Received
May 9, 2013
Report Date
April 12, 2013
Manufacturer
SYNTHES USA
Product Code
HRS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

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.

Description of Event or Problem · 1

DEVICE REPORT FROM SYNTHES (B)(4) REPORTS AN EVENT IN (B)(6) AS FOLLOWS: A PATIENT WAS TREATED ON AN UNKNOWN DATE WITH AN ANTEROLATERAL PLATE FOR A DISTAL TIBIAL FRACTURE. IT WAS REPORTED THAT THE PLATE BROKE POST-OPERATIVELY AND THE FRACTURE DID NOT HEAL. A REVISION SURGERY IS PLANNED FOR AN UNKNOWN DATE FOR THE FIXATION OF THE FRACTURE. THIS IS REPORT 1 OF 1 FOR COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
204599 HRS SYNTHES USA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention