BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PF PINS

    MDR report key: 3203550 · Received July 3, 2013

    Report

    Report Number
    1020279-2013-00342
    Event Type
    Injury
    Date Received
    July 3, 2013
    Date of Event
    May 7, 2013
    Report Date
    June 11, 2013
    Manufacturer
    SMITH & NEPHEW, INC.
    Product Code
    JDW
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    RI, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    REPORTED ON UF/IMPORTER REPORT # (B)(4).

    Description of Event or Problem · 1

    IT WAS REPORTED THAT DURING SURGERY THE PIN BROKE INTO TWO PIECES AND ONE PORTION WAS LEFT IN THE PATIENT'S BONE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    304080 PF PINS 3.5MM PF PIN 40MM JDW SMITH & NEPHEW, INC. 12FM07913

    Patients

    Seq Age Sex Outcome Treatment
    1 44 YR Hospitalization| R