FDA Adverse Event Injury Summary report: N

BIOBRIDGE PLATING SYSTEM

MDR report key: 5916066 · Received August 30, 2016

Report

Report Number
3005670412-2016-00011
Event Type
Injury
Date Received
August 30, 2016
Date of Event
August 2, 2016
Report Date
August 25, 2016
Manufacturer
ACUTE INNOVATIONS, LLC
Product Code
HRS
UDI-DI
10814493010609
PMA / PMN Number
K120163
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL MDRS ASSOCIATED WITH THIS EVENT: 3005670412-2016-00012 - PLATE 2; 3005670412-2016-00013 - PLATE 3.

Description of Event or Problem · 1

EXPLANT OF BIOBRIDGE PLATES USED IN THE PECTUS REPAIR OF A PEDIATRIC PATIENT. PLATES WERE IMPLANTED (B)(6) 2016. SURGEON KNEW IT WAS OFF-LABEL USE. THE PATIENT DEVELOPED PAINFUL DISCOMFORT DURING MOVEMENT WHICH LED TO REMOVAL OF THE THREE PLATES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
566557 BIOBRIDGE PLATING SYSTEM PLATE, FIXATION SYSTEM HRS ACUTE INNOVATIONS, LLC RRP1501 L1407008 10814493010609

Patients

Seq Age Sex Outcome Treatment
1 16 YR Required Intervention