FDA Adverse Event Malfunction Summary report: N

SCREW, FIXATION, BONE

MDR report key: 3864037 · Received June 10, 2014

Report

Report Number
2520274-2014-11733
Event Type
Malfunction
Date Received
June 10, 2014
Date of Event
May 14, 2014
Report Date
May 14, 2014
Manufacturer
SYNTHES (USA)
Product Code
HWC
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NZ
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. THIS REPORT IS FOR 3 SCREWS, PART AND LOT NUMBER UNKNOWN. WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. 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

DEVICE REPORT FROM SYNTHES (B)(6) REPORTS AN EVENT IN (B)(4) AS FOLLOWS: IT WAS REPORTED DURING AN ANTERIOR LUMBAR INTER-BODY FUSION THE SURGEON HAD DIFFICULTY SCREWING THREE DIFFERENT SCREWS INTO THE PLATE. THE FOURTH SCREW USED WAS ABLE TO SECURE THE PLATE. THIS RESULTED IN A 20 MINUTE DELAY IN SURGERY; NO ADVERSE EVENT WAS REPORTED WITH THE PATIENT. THIS REPORT IS FOR 3 SCREWS, PART AND LOT NUMBER UNKNOWN. THIS IS REPORT 3 OF 3 FOR (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
340752 SCREW, FIXATION, BONE HWC SYNTHES (USA)

Patients

Seq Age Sex Outcome Treatment
1