FDA Adverse Event Injury Summary report: N

BIOMET MICROFIXATION FACIAL PLATING SYSTEM

MDR report key: 4408887 · Received January 12, 2015

Report

Report Number
0001032347-2015-00011
Event Type
Injury
Date Received
January 12, 2015
Report Date
December 19, 2014
Manufacturer
BIOMET MICROFIXATION
Product Code
JEY
PMA / PMN Number
PK121589
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE PART AND LOT HISTORY OF THE IMPLANTED UNIT IS UNKNOWN; THEREFORE, THE DEVICE HISTORY RECORDS ARE UNABLE TO BE REVIEWED. THE WARNINGS IN THE PACKAGE INSERT STATE THIS TYPE OF EVENT CAN OCCUR. 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. IMPLANT AND EXPLANT DATES ARE UNKNOWN. FILE TWO OF THREE FOR THE SAME EVENT.

Description of Event or Problem · 1

A REVISION SURGERY DUE TO INFECTION WAS REPORTED. THE SURGEON HAS REQUESTED AN HTR PEKK IMPLANT TO REPLACE THE HTR PMMA IMPLANT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
27181 BIOMET MICROFIXATION FACIAL PLATING SYSTEM SCREW JEY BIOMET MICROFIXATION N/A UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R