BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EBA2

    MDR report key: 4848125 · Received June 11, 2015

    Report

    Report Number
    3009530665-2015-00001
    Event Type
    Injury
    Date Received
    June 11, 2015
    Date of Event
    May 15, 2015
    Report Date
    June 8, 2015
    Manufacturer
    CITIEFFE S.R.L.
    Product Code
    HSB
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    FL, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    IMPLANT BREAKAGE OF CEPHALIC SCREW ON INTRAMEDULLARY NAIL FOR REVERSE OBLIQUE TROCHANTERIC FRACTURE. MFR # 3003249380-2015-00001.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    381010 EBA2 PROXIMAL FEMORAL NAIL CEPHALIC SCREW HSB CITIEFFE S.R.L. EBA-7110 0PD017990000

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Required Intervention