FDA Adverse Event Injury Summary report: N

SCREW, FIXATION, BONE

MDR report key: 4242392 · Received November 11, 2014

Report

Report Number
2520274-2014-14625
Event Type
Injury
Date Received
November 11, 2014
Report Date
October 15, 2014
Manufacturer
SYNTHES (USA)
Product Code
HWC
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. THIS REPORT IS FOR DYNAMIC LOCKING SCREWS, QUANTITY, PART AND LOT NUMBER UNKNOWN. (B)(4) POSSIBLE ALLERGIC REACTION WHICH CAN BE ASSUMED BY THE EVENT DESCRIPTION BUT HAS NOT BEEN VERIFIED. 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. 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 THE PATIENT HAS THREE FISTULA´S AND THE SURGEON HAS HEARD RUMORS OF BROKEN DYNAMIC LOCKING SCREWS (DLS) AND IS AFRAID TO REMOVE THE SCREWS. PATIENT WAS TESTED POST-OPERATIVE AND HAS AN ALLERGY FOR COBALT CHROME. THIS REPORT IS FOR THE UNKNOWN DYNAMIC LOCKING SCREWS. THIS IS REPORT 1 OF 2 FOR (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
727723 SCREW, FIXATION, BONE HWC SYNTHES (USA)

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention