FDA Adverse Event Injury Summary report: N

11MM TI CANNULATED FEMORAL NAIL 400MM

MDR report key: 3142333 · Received June 3, 2013

Report

Report Number
2520274-2013-02914
Event Type
Injury
Date Received
June 3, 2013
Report Date
May 7, 2013
Manufacturer
SYNTHES USA
Product Code
JDN
PMA / PMN Number
K954856
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO
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. ADDITIONAL INFORMATION: PATIENT ID - CASE #: (B)(6). PLACEHOLDER.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT IMPLANTED WITH A SYNTHES TITANIUM FEMORAL NAIL AND TWO LOCKING SCREWS WAS REVISED DUE TO A BROKEN PROXIMAL DYNAMIC SCREW IN ADDITION TO A NON UNION. THIS IS REPORT 1 OF 2 FOR COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
243225 11MM TI CANNULATED FEMORAL NAIL 400MM JDN SYNTHES USA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention