FDA Adverse Event
Malfunction
Summary report: N
SIGN IM NAIL
MDR report key: 5915523
·
Received August 30, 2016
Report
- Report Number
- 3034525-2016-00246
- Event Type
- Malfunction
- Date Received
- August 30, 2016
- Report Date
- August 25, 2016
- Manufacturer
- SIGN FRACTURE CARE INTERNATIONAL
- Product Code
- HSB
- PMA / PMN Number
- K022632
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PK
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
A PRODUCT INVESTIGATION WAS PERFORMED FOR THIS DEVICE. THE ACTUAL DEVICE WAS NOT RETURNED TO THE MANUFACTURER FOR EVALUATION. THE ROOT CAUSE OF THE BROKEN LOCKING BOLT IS UNDETERMINED. SIGN FRACTURE CARE INTERNATIONAL WILL CONTINUE TO MONITOR THESE EVENTS AS PART OF OUR POST MARKET ACTIVITIES.
Description of Event or Problem · 1
WE BECAME AWARE ON (B)(6) 2016, THAT A SIGN LOCKING BOLT WAS BROKEN. NO CASE OR CAUSE DATA PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 565896 | SIGN IM NAIL | INTRAMEDULLARY FIXATION ROD | HSB | SIGN FRACTURE CARE INTERNATIONAL |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 25 YR |