FDA Adverse Event
Injury
Summary report: N
BIOSTEON WEDGE INTERFERENCE SCREW
MDR report key: 3855870
·
Received May 1, 2014
Report
- Report Number
- 2249697-2014-00005
- Event Type
- Injury
- Date Received
- May 1, 2014
- Date of Event
- January 29, 2014
- Report Date
- April 30, 2014
- Manufacturer
- BIOCOMPOSITES LTD
- Product Code
- HWC
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Distributor report
- Reporter Location
- RO
- Reporter Occupation
- PHYSICIAN
Narratives
Description of Event or Problem · 1
THE DOCTOR REPORTED TO SALES MANAGER THAT AN IMPLANTED BIOSTEON INTERFERENCE SCREW WAS BROKEN, VERY CLOSE TO THE TIP OF THE SCREW, AT 7 MONTHS AFTER THE IMPLANTATION. THE RESPECTIVE SCREW WAS EXPLANTED AND SENT BY DOCTOR TO A THIRD PARTY ((B)(4)) FOR MICROSCOPIC ANALYZE. IT WAS FURTHER REPORTED THAT SCREW IS GOING TO BE RETURNED FOR MANUFACTURER'S INVESTIGATION AS SOON AS IT WILL BE SENT BACK TO DOCTOR AND THEREFORE IT MIGHT BECOME AVAILABLE FOR RETURNING.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 262127 | BIOSTEON WEDGE INTERFERENCE SCREW | SCREW, FIXATION, BONE | HWC | BIOCOMPOSITES LTD | 0312PH132 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 28 YR | Other| R |