FDA Adverse Event Malfunction Summary report: N

TOMOFIX TIB-HEAD-PL LAT PROX R 3HO TAN

MDR report key: 3243063 · Received July 23, 2013

Report

Report Number
8030965-2013-04392
Event Type
Malfunction
Date Received
July 23, 2013
Date of Event
October 3, 2012
Report Date
June 27, 2013
Manufacturer
SYNTHES GMBH
Product Code
KTT
PMA / PMN Number
K023941
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. THE MANUFACTURING DOCUMENTS WERE REVIEWED AND NO COMPLAINT RELATED ISSUES WERE FOUND. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED.

Description of Event or Problem · 1

DEVICE REPORT FROM SYNTHES (B)(6) REPORTS AN EVENT IN (B)(6) AS FOLLOWS: THE PATIENT HAD A AO TYPE 41B1 (RIGHT). THE SURGEON CONDUCTED AN OPEN REDUCTION INTERNAL FIXATION (ORIF) FOR AO TYPE 41B1 ON (B)(6) 2011. AFTER THE BONE HEALED, THE SURGEON TRIED TO EXTRACT THE DEVICES ON (B)(6) 2012. HE COULD NOT EXTRACT TWO LOCKING SCREWS IN THE SHAFT AND THEY REMAINED IN THE PATIENTS BODY. IN (B)(6) 2013, THE PATIENT EXPRESSED CONCERN TO THE SURGEON AS TO WHY THE DEVICES COULD NOT BE REMOVED AND THE EFFECT ON HER HEALTH. THIS IS REPORT 1 OF 4 FOR COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
343892 TOMOFIX TIB-HEAD-PL LAT PROX R 3HO TAN KTT SYNTHES GMBH 2737896

Patients

Seq Age Sex Outcome Treatment
1