MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor report with the FDA on 2015-09-25 for MCP SZ. 30 DISTAL WW MCP-100-30D-WW manufactured by Ascension Orthopedics.
[26965866]
It was reported the device fractured. It was reported that the patient is a mechanic, he works with his hands. He had returned to work and was on light duty. The patient reported hitting/jamming his finger. "the detailed description by the patient did not sound like anything that would have caused the implant to fracture. " following the incident, the patient had pain and swelling, leading to the office visit and x-rays where the fracture was discovered. Currently the patient is removed from working and is waiting for further treatment recommendation from the care team. A revision procedure is expected. Operative report from initial surgery (b)(6) 2015: preoperative diagnosis: severe osteoarthritis of the left mcp joint. Procedure: left hand third mcp joint: resectional arthroplasty with ascension orthopedics pyrocarbon implant (size #30). Application of volar splint. Summary of report: uneventful implantation procedure.
Patient Sequence No: 1, Text Type: D, B5
[34372716]
Additional information received 18nov2015: the revision surgery has been completed as of yesterday (b)(6) 2015. I have the explanted implants on hand that have been washed and sterilized. Integra has completed their internal investigation on 1dec2015. The investigation activities included: methods: evaluation of actual device. Review of device history records. Review of complaint history. Results: the review of manufacturing records showed no evidence of nonconformance that could have caused or contributed to the reported defect. (b)(4). Conclusion: the investigation determined that the fracture is most likely the result of a traumatic injury suffered by the patient.
Patient Sequence No: 1, Text Type: N, H10
[34372717]
.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 1651501-2015-00035 |
MDR Report Key | 5105584 |
Report Source | DISTRIBUTOR |
Date Received | 2015-09-25 |
Date of Report | 2015-09-03 |
Date of Event | 2015-11-17 |
Date Mfgr Received | 2015-11-18 |
Device Manufacturer Date | 2014-12-01 |
Date Added to Maude | 2015-09-25 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Reporter Occupation | DENTAL ASSISTANT |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | USER MARIA LEONARD |
Manufacturer Street | 311 ENTERPRISE DRIVE |
Manufacturer City | PLAINSBORO NJ 08536 |
Manufacturer Country | US |
Manufacturer Postal | 08536 |
Manufacturer Phone | 6099362393 |
Manufacturer G1 | ASCENSION ORTHOPEDICS |
Manufacturer Street | 8700 CAMERON ROAD #100 |
Manufacturer City | AUSTIN TX 78754 |
Manufacturer Country | US |
Manufacturer Postal Code | 78754 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | MCP SZ. 30 DISTAL WW |
Generic Name | MCP |
Product Code | NEG |
Date Received | 2015-09-25 |
Returned To Mfg | 2015-11-20 |
Catalog Number | MCP-100-30D-WW |
Lot Number | 142698T |
Operator | HEALTH PROFESSIONAL |
Device Availability | R |
Device Age | DA |
Device Eval'ed by Mfgr | Y |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | ASCENSION ORTHOPEDICS |
Manufacturer Address | 8700 CAMERON ROAD #100 8700 CAMERON ROAD #100 AUSTIN TX 78754 US 78754 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Required No Informationntervention | 2015-09-25 |