FDA Adverse Event Other Summary report: N

BREMER 3D CROWN

MDR report key: 388530 · Received April 11, 2002

Report

Report Number
1526439-2002-00022
Event Type
Other
Date Received
April 11, 2002
Report Date
April 11, 2002
Manufacturer
DEPUY ACROMED
Product Code
HAX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED TO DEPUY ACROMED THAT A SCREW JAMMED IN THE SCREW HOLE OF A BREMER HALO. ACCORDING TO THE COMPLAINANT, THE SCREW JAMMED AND THE HALO HAD TO BE REMOVED AND REPLACED WITH ANOTHER HALO. THERE WERE NO ADVERSE CONSEQUENCES TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BREMER 3D CROWN 12" SLIDER PAIR HAX DEPUY ACROMED NA 044122

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other