FDA Adverse Event Injury Summary report: N

OPUS MAGNUM IMPLANT

MDR report key: 548967 · Received October 18, 2004

Report

Report Number
2032380-2004-00002
Event Type
Injury
Date Received
October 18, 2004
Date of Event
June 23, 2004
Manufacturer
OPUS MEDICAL, INC.
Product Code
HTY
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

PT RETURNED TO THE CLINIC POST-OP COMPLAINING OF PAIN AT NIGHT AND DURING OVERHEAD ACTIVITIES. THE SURGEON ORDERED AN ARTERIOGRAM WHICH SHOWED THAT THE MAGNUM IMPLANT MIGRATED OUT OF THE IMPLANT SITE AND INTO THE INTRACAPSULAR SPACE. ADDITIONALLY, A RE-TEAR OF THE ROTATOR CUFF WAS OBSERVED. THE SURGEON VIA A MINI-OPEN INCISION REMOVED THE LOOSE IMPLANT AND PERFORMED A REVISION OF THE REPAIR UTILIZING THE STANDARD TRANSOSSEOUS TUNNELING TECHNIQUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OPUS MAGNUM IMPLANT ORTHOPAEDIC BONE ANCHOR HTY OPUS MEDICAL, INC. OM-1500 UNK

Patients

Seq Age Sex Outcome Treatment
1 56 YR Hospitalization| R