FDA Adverse Event Injury Summary report: N

PSI SD800.418

MDR report key: 3738108 · Received April 10, 2014

Report

Report Number
2530088-2014-10052
Event Type
Injury
Date Received
April 10, 2014
Report Date
March 21, 2014
Manufacturer
SYNTHES BRANDYWINE
Product Code
GXN
PMA / PMN Number
PK033868
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. A REVIEW OF THE DEVICE HISTORY RECORDS HAS BEEN REQUESTED. WEIGHT REPORTED AS (B)(6). EVENT DATE: UNKNOWN. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSISA REVIEW OF THE DEVICE HISTORY RECORDS WAS PERFORMED AND NO COMPLAINT RELATED ISSUES WERE FOUND.IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THERE WAS A REVISION CRANIOPLASTY AND PEEK IMPLANT REMOVAL ON (B)(6) 2014 DUE TO PATIENT PAIN. THE PATIENT HAD THREE PEEK IMPLANTS INSERTED ON A CRANIOPLASTY PROCEDURE ON (B)(6) 2013. THE PATIENT CAME IN APPROXIMATELY SIX TO EIGHT WEEKS AGO COMPLAINING OF PAIN FROM THE RIGHT-SIDE IMPLANT. THE SURGEON TOOK A COMPUTERIZED TOMOGRAPHY (CT) SCAN AND DID NOT SEE ANYTHING WRONG WITH THE IMPLANTS, BUT DECIDED TO TAKE ALL THE IMPLANTS, PLATES, AND SCREWS OUT TO SEE IF IT WOULD ALLEVIATE THE PAIN ISSUE. THE EXPLANT PROCEDURE WAS COMPLETE SUCCESSFULLY AND IT WAS NOTED THAT THE FIXATION OF THE IMPLANTS SEEMED STABLE AND SURGEON REMOVED DEVICES EASILY. THE PATIENT IS DOING WELL. THERE WAS NO DELAY IN SURGERY TIME. THIS IS REPORT 2 OF 16 FOR (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
217263 PSI SD800.418 PLATE,CRANIOPLASTY,PREFORMED, NONALTERABLE GXN SYNTHES BRANDYWINE 7410341

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention