FDA Adverse Event Other Summary report: N

ALVEOLAR RIDGE DISTRACTOR PLATE

MDR report key: 384397 · Received March 22, 2002

Report

Report Number
1032347-2002-00006
Event Type
Other
Date Received
March 22, 2002
Report Date
March 20, 2002
Manufacturer
WALTER LORENZ SURGICAL, INC.
Product Code
MQN
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

DURING INITIAL SURGERY FOR MANDIBULAR DISTRACTION, THE DEVICE WAS PLACED SEVERAL TIMES AND THEN THE DOCTOR DECIDED TO GO WITH A LARGER DISTRACTOR. SEVEN (7) DAYS AFTER THE SURGERY, THE SCREWS BEGAN PULLING OUT OF THE BONE. A REVISION SURGERY WAS PERFORMED AND THE DISTRACTOR WAS SUCCESSFULLY REATTACHED TO THE BONE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ALVEOLAR RIDGE DISTRACTOR PLATE * MQN WALTER LORENZ SURGICAL, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other