MAUDE Adverse Event Report: SYNTHES GMBH EXPERT TN Ø11 CANN L450 TAN LIGHT GREEN; NAIL, FIXATION, BONE

Catalog Number 04.004.570

Device Problem Adverse Event Without Identified Device or Use Problem (2993)

Patient Problem Fluid Discharge (2686)

Event Date 07/01/2022

Event Type  Injury  

Manufacturer Narrative

Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.If the information is unknown, not available or does not apply, the section/field of the form is left blank.Complainant part is not expected to be returned for manufacturer review/investigation.Device is not distributed in the united states, but is similar to device marketed in the usa.Without a lot number the device history records review could not be completed.Product was not returned.Based on the information available, it has been determined that no corrective and/or preventative action is proposed.This complaint will be accounted for and monitored via post market surveillance activities.If additional information is made available, the investigation will be updated as applicable.Device was used for treatment, not diagnosis.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.

Event Description

Device report from synthes reports an event in hong kong as follows: the site hoq (hong kong) reported an adverse event in our database which is considered (possibly) related to the device.Subject (b)(6).Ae1: postoperative adverse event: "other ae related to the procedure or implant ¿ wound discharge" is the ae related to the tibial fracture and/or treatment of tibial fracture? "yes" is the ae related to the device? "possible" dps implant was used.This report is for one (1) expert tn ø11 cann l450 tan light green.This is report 1 of 5 for complaint (b)(4).

Event Description

Device report from synthes reports an event in hong kong as follows: it was reported that the patient underwent surgery on (b)(6) 2022 with the products in question.On (b)(6) 2022, it was noted that the patient experienced wound discharge after surgery.There was no infection, and the patient was given non-operative treatment.The patient was discharged home on (b)(6) 2022.

• Brand Name: EXPERT TN Ø11 CANN L450 TAN LIGHT GREEN
• Type of Device: NAIL, FIXATION, BONE
• Manufacturer (Section D): SYNTHES GMBH; eimattstrasse 3; oberdorf 4436 ; SZ 4436
• Manufacturer (Section G): MONUMENT; 1101 synthes avenue; monument CO 80132
• Manufacturer Contact: kate karberg ; 1302 wright lane east; west chester, PA 19380 ; 3035526892
• MDR Report Key: 15816607
• MDR Text Key: 303845457
• Report Number: 8030965-2022-09979
• Device Sequence Number: 1
• Product Code: JDS
• UDI-Device Identifier: 07611819171398
• UDI-Public: (01)07611819171398
• Combination Product (y/n): N
• Reporter Country Code: HK
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Other,Foreign,Health Professional
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 11/17/2022
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Device Catalogue Number: 04.004.570
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Date Manufacturer Received: 01/12/2023
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: Yes
• Type of Device Usage: Unknown
• Patient Sequence Number: 1
• Treatment: UNK - SCREWS: NAIL DISTAL LOCKING; UNK - SCREWS: NAIL DISTAL LOCKING; UNK - SCREWS: NAIL DISTAL LOCKING; UNK - SCREWS: NAIL PROXIMAL LOCKING
• Patient Outcome(s): Required Intervention
• Patient Sex: Male
• Patient Weight: 72 KG