FDA Adverse Event Injury Summary report: N

SUBTALAR M.B.A.

MDR report key: 510292 · Received February 4, 2004

Report

Report Number
2028840-2004-00006
Event Type
Injury
Date Received
February 4, 2004
Date of Event
January 26, 2004
Report Date
February 4, 2004
Manufacturer
KINETIKOS MEDICAL, INC.
Product Code
ISH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

ON FEB. 04, 2003, K.M.I. WAS NOTIFIED OF THE EXPLANT OF A 9MM MBA 10 MONTHS AFTER ITS ORIGINAL IMPLANT DATE TO ADDRESS PAIN REPORTED BY THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SUBTALAR M.B.A. ORTHOPAEDIC FOOT IMPLANT ISH KINETIKOS MEDICAL, INC. 05-0109 7773-9-7956

Patients

Seq Age Sex Outcome Treatment
1 70 YR Other