FDA Adverse Event Injury Summary report: N

BIOMET MICROFIXATION MANDIBULAR FRACTURE/RECONSTRUCTION DEVICES AND PREBENT PLAT

MDR report key: 4231791 · Received November 6, 2014

Report

Report Number
0001032347-2014-00393
Event Type
Injury
Date Received
November 6, 2014
Date of Event
October 17, 2014
Report Date
October 14, 2014
Manufacturer
BIOMET MICROFIXATION
Product Code
HWC
PMA / PMN Number
PK113512
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

WITHOUT A PRODUCT RETURN, NO PRODUCT EVALUATION IS ABLE TO BE CONDUCTED. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A VALID CONCLUSION ABOUT THE CAUSE OF THIS EVENT. IF ADDITIONAL INFORMATION IS OBTAINED THAT ADDS VALUE TO THE RELEVANT CONTENT OF THIS REPORT AND/OR A CONCLUSION CAN BE DRAWN, A FOLLOW-UP REPORT WILL BE SENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SURGEON FOUND BROKEN TMS 2.4MM SCREWS. A REVISION SURGERY WAS SCHEDULED FOR (B)(6) 2014. THE CUSTOMER FOLLOWED UP WITH THE SALES REP AND NO NEW INFORMATION HAS BEEN RECEIVED PER THE COMPLAINT FILE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
715213 BIOMET MICROFIXATION MANDIBULAR FRACTURE/RECONSTRUCTION DEVICES AND PREBENT PLAT TMS SCREW HWC BIOMET MICROFIXATION N/A UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R