FDA Adverse Event Injury Summary report: N

SYNTHES ORTHOPEDICS

MDR report key: 988508 · Received January 22, 2008

Report

Report Number
MW5005129
Event Type
Injury
Date Received
January 22, 2008
Date of Event
October 4, 2007
Report Date
January 8, 2008
Manufacturer
SYNTHES (USA)
Product Code
JDS
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

FAILED FEMORAL NAIL SYNTHES. END CAP CAME LOOSE, SPIRAL BLADE BACKED OUT. FOUR PIECE'S TO NAIL. SYNTHES 12MM CANNULATED FEMORAL NAIL, CAT # 474.2365 MCN #4334916, EXP. 12/2010. SYNTHES SPIRAL BLADE 80MM CAT #456.80, LOT # 5180079. 5.0MM SYNTHES LOCKING SCREW CAT # 459.940, LOT # 4578940. END CAP SYNTHES CAT # 457.010, LOT # 4054901.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNTHES ORTHOPEDICS SYNTHES 12MM CANNULATED FEMORAL NAIL JDS SYNTHES (USA) 4334916
2 SYNTHES ORTHOPEDICS SYNTHES SPIRAL BLADE 80MM KTW SYNTHES (USA) 5180079
3 SYNTHES ORTHOPEDICS 5.0MM SYNTHES LOCKING SCREW HWC SYNTHES (USA) 4578940
4 SYNTHES ORTHOPEDIC'S END CAP SYNTHES MQP SYNTHES (USA) 4054901

Patients

Seq Age Sex Outcome Treatment
1 14 YR Required Intervention