FDA Adverse Event Injury Summary report: N

NOVATION BONE SCREW 6.5MM

MDR report key: 4173186 · Received September 19, 2014

Report

Report Number
1038671-2014-00437
Event Type
Injury
Date Received
September 19, 2014
Date of Event
August 26, 2014
Report Date
September 16, 2014
Manufacturer
EXACTECH, INC.
Product Code
HWC
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

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

REVISION OF HIP COMPONENTS DUE TO SUBOPTIMAL ORIENTATION OF THE ACETABULAR. THE SURGEON DOES NOT CONSIDER REVISION TO BE DEVICE RELATED. THIS EVENT REPORT WAS RECEIVED THROUGH CLINICAL DATA COLLECTION ACTIVITIES. THIS EVENT TOOK PLACE OUTSIDE OF THE UNITED STATES, IN COLOMBIA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
583199 NOVATION BONE SCREW 6.5MM BONE SCREW 6.5MM HWC EXACTECH, INC.

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R