FDA Adverse Event
Malfunction
Summary report: N
2520274-2013-03832
MDR report key: 3192582
·
Received June 27, 2013
Report
- Report Number
- 2520274-2013-03832
- Event Type
- Malfunction
- Date Received
- June 27, 2013
- Date of Event
- May 30, 2013
- Report Date
- May 30, 2013
- Manufacturer
- SYNTHES USA
- Product Code
- HWC
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OR, 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.
Description of Event or Problem · 1
DURING AN OPEN REDUCTION INTERNAL FIXATION (ORIF) DISTAL HUMERUS WITH OLECRANON OSTEOTOMY, TWO UNKNOWN DISTAL VARIABLE ANGLE (VA) LOCKING SCREWS IN THE VA-LCP LATERAL DISTAL (LOCKING COMPRESSION) PLATE DID NOT FULLY ENGAGE IN THE LOCKING HOLES OF THE PLATE. INSTEAD THE SCREWS JUST CONTINUED TO SPIN. THE SURGEON DECIDED TO LEAVE SCREWS IN PLACE RATHER THAN ATTEMPT TO REMOVE THEM. NO PATIENT HARM. THIS REPORT IS FOR TWO UNKNOWN LOCKING SCREWS. THIS IS REPORT 2 OF 2 FOR (B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 294491 | HWC | SYNTHES USA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |