FDA Adverse Event Other Summary report: N

TAPERLOC FEMORAL RASP PROVISIONAL

MDR report key: 863990 · Received June 11, 2007

Report

Report Number
1825034-2007-00073
Event Type
Other
Date Received
June 11, 2007
Date of Event
May 9, 2007
Report Date
May 21, 2007
Manufacturer
BIOMET, INC.
Product Code
HTR
PMA / PMN Number
EXEMPT
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CURRENT INFO IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. NO FURTHER COMPLICATIONS HAVE BEEN REPORTED. THERE ARE WARNINGS IN THE PACKAGE INSERT THAT STATE THAT THIS TYPE OF EVENT CAN OCCUR. EVALUATION OF RETURNED DEVICE FOUND EVIDENCE OF FRACTURE DUE TO BENDING OVERLOAD. THIS REPORT FILED ON JUNE 11, 2007.

Description of Event or Problem · 1

IT WAS REPORTED THAT PT UNDERWENT LEFT TOTAL HIP ARTHROPLASTY IN 2007. TIP SECTION OF RASP FRACTURED IN PT'S INTERMEDULLARY CANAL AND WAS NOTED ON POST-OPERATIVE RADIOGRAPHS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TAPERLOC FEMORAL RASP PROVISIONAL HTR BIOMET, INC. NA 385100

Patients

Seq Age Sex Outcome Treatment
1 75 YR Other| S