FDA Adverse Event Malfunction Summary report: N

CLICKX LOCKCAP T25 TAN

MDR report key: 3193434 · Received June 27, 2013

Report

Report Number
8030965-2013-04161
Event Type
Malfunction
Date Received
June 27, 2013
Report Date
July 20, 2012
Manufacturer
SYNTHES GMBH
Product Code
HWC
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SYNTHES IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO FDA WARNING LETTER DATED FEBRUARY 2012. DEVICE(S) LISTED IN THIS REPORT IS (ARE) USED FOR TREATMENT, NOT DIAGNOSIS. ANY ADDITIONAL INFORMATION RECEIVED REGARDING THIS EVENT AFTER FILING THIS REPORT SHALL BE FILED ON A SUPPLEMENTAL MDR. A REVIEW OF THE DEVICE HISTORY RECORDS HAS BEEN REQUESTED. THE MEASURABLE DIMENSIONS OF THE SENT LOCKING CAP WERE REVIEWED. IT WAS DETERMINED THAT THE DIMENSIONS ARE CONSISTENT WITH THE DIAGRAMS AND SPECIFICATIONS. THE EXACT CAUSE OF THE DAMAGE COULD NOT BE DETERMINED THROUGH THE VISUAL AND MANUFACTURING DATA INVESTIGATION. AN ERROR IN MATERIAL OR ASSEMBLY CAN BE EXCLUDED. THIS COMPLAINT HAS BEEN DETERMINED TO BE INDETERMINATE. (B)(6). DEVICE IS NOT DISTRIBUTED IN THE UNITED STATES, BUT IS SIMILAR TO DEVICE MARKETED IN THE USA.

Additional Manufacturer Narrative · 1

SYNTHES IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO FDA WARNING LETTER DATED FEBRUARY 2012. DEVICE(S) LISTED IN THIS REPORT IS (ARE) USED FOR TREATMENT, NOT DIAGNOSIS. ANY ADDITIONAL INFORMATION RECEIVED REGARDING THIS EVENT AFTER FILING THIS REPORT SHALL BE FILED ON A SUPPLEMENTAL MDR. MANUFACTURING DOCUMENTS WERE REVIEWED AND NO COMPLAINT RELATED ISSUES WERE FOUND. PLACEHOLDER.

Description of Event or Problem · 1

SADDLE LOOSENED FROM LOCKING CAP. THIS IS 1 OF 1 REPORT FOR THIS COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
291942 CLICKX LOCKCAP T25 TAN HWC SYNTHES GMBH 7923671

Patients

Seq Age Sex Outcome Treatment
1