FDA Adverse Event Injury Summary report: N

EQUINOXE SHOULDER SYSTEM

MDR report key: 3981451 · Received July 25, 2014

Report

Report Number
1038671-2014-00297
Event Type
Injury
Date Received
July 25, 2014
Report Date
July 23, 2014
Manufacturer
EXACTECH, INC.
Product Code
KWS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS EVENT REPORT WAS RECEIVED THROUGH CLINICAL DATA COLLECTION ACTIVITIES. THE CONTRIBUTION OF THE DEVICES TO THE EXPERIENCE REPORTED COULD NOT BE DETERMINED AS THE DEVICES WERE NOT RETURNED FOR EVALUATION.

Description of Event or Problem · 1

PATIENT PRESENTS WITH SCAPULAR SPINE FRACTURE FROM FALL RESULTING IN POSSIBLE PERSISTENT PROBLEM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
436645 EQUINOXE SHOULDER SYSTEM SHOULDER SYSTEM KWS EXACTECH, INC.

Patients

Seq Age Sex Outcome Treatment
1 145 YR Other