inforMED
MalfunctionKWO

CMF CUSTOMIZED IMPLANT KIT LARGE

Received Nov 22, 2011 · Event occurred Nov 1, 2011

Report 2249697-2011-01654 · MDR key 2397404

Device

Generic name

Implant

Model number

NA

Catalog number

5444-0-300

Lot number

UNK

Product problems

  • Crack

Patient

UNK

  • No Information

Narrative

Additional Manufacturer Narrative

AN EVALUATION OF THE DEVICE CANNOT BE PERFORMED AS THE DEVICE REMAINED IMPLANTED IN THE PATIENT AND WAS NOT RETURNED TO THE MANUFACTURER. ADDITIONAL INFORMATION PERTAINING TO THE DEVICE(S) REFERENCED IN THIS REPORT (INCLUDING X-RAYS AND MEDICAL RECORDS) WAS REQUESTED. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, THE EVALUATION SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem

THE SURGEON WAS PUTTING THE SECOND OR THIRD SCREW INTO THE IMPLANT AND AS THE SCREW WAS TIGHTENING THE IMPLANT CRACKED. THEY ENDED UP IMPLANTING THE PRODUCT AND THE SCREW CONTINUED TO HOLD.

Remedial action

  • Other