FDA Adverse Event Injury Summary report: N

7.3MM CANNULATED LOCKING SCREW 75MM

MDR report key: 3962230 · Received July 28, 2014

Report

Report Number
2520274-2014-12877
Event Type
Injury
Date Received
July 28, 2014
Report Date
July 1, 2014
Manufacturer
SYNTHES USA
Product Code
HWC
PMA / PMN Number
PK000066
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. (B)(6). THE INVESTIGATION COULD NOT BE COMPLETED AND NO CONCLUSION COULD BE DRAWN AS NO DEVICE WAS RETURNED AND NO LOT NUMBER WAS PROVIDED. 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

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

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)(4) REPORTS AN EVENT IN (B)(6) AS FOLLOWS: IT WAS REPORTED THAT THE HOSPITAL CALLED TO INQUIRE ABOUT THE SYSTEM USED FOR THIS CASE AS THEY COULD NOT GET THE DETAILS FROM THEIR DATA, BY PROVIDING PATIENT DETAILS, DATA WAS RETRIEVED FROM SAP. PER THE HOSPITAL, THE PATIENT HAS A NONUNION AND AS A RESULT, THE IMPLANT BROKEN. THE PATIENT WILL HAVE A REVISION SURGERY IN INDIA. NO FURTHER DETAILS CAN BE PROVIDED. THIS COMPLAINT INVOLVES (3) DEVICES. THIS REPORT IS 2 OF 3 FOR (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
439566 7.3MM CANNULATED LOCKING SCREW 75MM SCREW,FIXATION,BONE HWC SYNTHES USA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention