BEUDAMED
    FDA Adverse Event Injury Summary report: N

    WRIGHT MEDICAL

    MDR report key: 486077 · Received September 26, 2003

    Report

    Report Number
    486077
    Event Type
    Injury
    Date Received
    September 26, 2003
    Date of Event
    August 19, 2003
    Report Date
    August 27, 2003
    Manufacturer
    WRIGHT MEDICAL TECHNOLOGY
    Product Code
    KWF
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT PRESENTED TO DR WITH PAINFUL JOINT AFTER ORIGINAL SURGERY IN 2003. PT HAD TO RETURN TO SURGERY TO HAVE IMPLANT REPLACED 6 MONTHS LATER. DR FOUND ORIGINAL IMPLANT WAS BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WRIGHT MEDICAL FINGER JOINT IMPLANT WITH GROMMET SIZE 4 KWF WRIGHT MEDICAL TECHNOLOGY * 12235760

    Patients

    Seq Age Sex Outcome Treatment
    1 88 YR Required Intervention