FDA Adverse Event Other Summary report: N

WRIST ARTHRODESIS NAIL SYSTEM

MDR report key: 3565586 · Received December 30, 2013

Report

Report Number
3006742481-2013-00009
Event Type
Other
Date Received
December 30, 2013
Date of Event
November 21, 2013
Report Date
December 27, 2013
Manufacturer
SKELETAL DYNAMICS LLC
Product Code
HSB
PMA / PMN Number
K092720
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CURRENT INFO IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF EVENT. REVIEW OF MFG RECORDS DEMONSTRATES THAT ALL MATERIALS MET RELEASE CRITERIA.

Description of Event or Problem · 1

IT WAS REPORTED THAT DEVICE WAS REMOVED. IT WAS ALSO REPORTED THAT PT HAD WORK RELATED INJURY, PRIOR SURGERY, AND DEVELOPMENT OF SIGNIFICANT PHYSIOLOGICAL CHANGES PRIOR TO DEVICE IMPLANT PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
680217 WRIST ARTHRODESIS NAIL SYSTEM NONE HSB SKELETAL DYNAMICS LLC AZ0311001 AZ1110010

Patients

Seq Age Sex Outcome Treatment
1 33 YR Other