FDA Adverse Event Injury Summary report: N

9MM TI CANNULATED TIBIAL NAILL-EX/360MM-STERILE

MDR report key: 4173399 · Received October 15, 2014

Report

Report Number
1719045-2014-10510
Event Type
Injury
Date Received
October 15, 2014
Report Date
September 18, 2014
Manufacturer
SYNTHES MONUMENT
Product Code
JDS
PMA / PMN Number
PK040762
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DEVICE IS NOT DISTRIBUTED IN THE UNITED STATES, BUT IS SIMILAR TO DEVICE MARKETED IN THE USA. 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. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. 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

A REVIEW OF DEPUY SYNTHES MONUMENT DEVICE HISTORY RECORDS FOR MANUFACTURING REVEALED NO COMPLAINT RELATED ISSUES. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS.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

IT WAS REPORTED THAT A PATIENT EXPERIENCED A NON-UNION POST TIBIAL NAIL PROCEDURE. A REVISION WAS PERFORMED AND INCLUDED ANOTHER TIBIAL NAIL AND A FEMUR AUTOGRAFT. THE PROCEDURE WAS SUCCESSFULLY COMPLETED. THIS IS REPORT NUMBER 1 OF 2 FOR (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
653780 9MM TI CANNULATED TIBIAL NAILL-EX/360MM-STERILE NAIL, FIXATION, BONE JDS SYNTHES MONUMENT 6818284

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention