inforMED
InjuryEZX

PHYSICIAN DESIGNED CUSTOM ORTHOPEDIC IMPLANT

Received Apr 11, 2019 · Event occurred Aug 24, 2018

Report 3009189869-2019-00009 · MDR key 8504307

Device

Generic name

Physician Designed Custom Orthopedic Implant

Manufacturer

4web, Inc.

Model number

111117.07A

Catalog number

111117.07A

Lot number

40206181

Product problems

  • Break
  • Break

Patient

64 YR

  • Pain
  • Pain

Narrative

Additional Manufacturer Narrative

SUBJECT OF THIS FILING WAS UNIQUELY DESIGNED FOR THIS PATIENT'S SPECIFIC PATHOLOGY BY THE PRESCRIBING PHYSICIAN.

Description of Event or Problem

IT WAS REPORTED THAT THE PATIENT PRESENTED WITH PAIN DUE TO THE IMPLANT FRACTURING WHICH LED TO REVISION.