FDA Adverse Event Injury Summary report: N

HAMMERLOCK 1.1

MDR report key: 4663546 · Received April 3, 2015

Report

Report Number
1649263-2015-00004
Event Type
Injury
Date Received
April 3, 2015
Report Date
April 3, 2015
Manufacturer
BIOMEDICAL ENT., INC.
Product Code
HTY
PMA / PMN Number
K131640
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

ON (B)(6) 2015, A BME DISTRIBUTOR RECEIVED AN X-RAY FROM A SALES REP WHICH REVEALED A HAMMERLOCK 1.1 (MODEL AND SIZE UNAVAILABLE) INSERTED AT AN ANGLE. ONE OF THE IMPLANT LEGS BROKE THE CORTICAL WALL AND WAS OUTSIDE OF THE BONE. AS FUSION HAD ALREADY TAKEN PLACE, THE SURGEON CLIPPED OFF THE PROTRUDING IMPLANT LEG AND DID NOT EXPLANT THE DEVICE. NO FURTHER DETAILS ARE AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
220581 HAMMERLOCK 1.1 PIN, FIXATION, SMOOTH, 21 CFR 888.3040 HTY BIOMEDICAL ENT., INC. UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention