MCP SZ. 30 DISTAL WW MCP-100-30D-WW

MAUDE Adverse Event Report

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.

Event Text Entries

[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


MAUDE Entry Details

Report Number1651501-2015-00035
MDR Report Key5105584
Report SourceDISTRIBUTOR
Date Received2015-09-25
Date of Report2015-09-03
Date of Event2015-11-17
Date Mfgr Received2015-11-18
Device Manufacturer Date2014-12-01
Date Added to Maude2015-09-25
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationDENTAL ASSISTANT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactUSER MARIA LEONARD
Manufacturer Street311 ENTERPRISE DRIVE
Manufacturer CityPLAINSBORO NJ 08536
Manufacturer CountryUS
Manufacturer Postal08536
Manufacturer Phone6099362393
Manufacturer G1ASCENSION ORTHOPEDICS
Manufacturer Street8700 CAMERON ROAD #100
Manufacturer CityAUSTIN TX 78754
Manufacturer CountryUS
Manufacturer Postal Code78754
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMCP SZ. 30 DISTAL WW
Generic NameMCP
Product CodeNEG
Date Received2015-09-25
Returned To Mfg2015-11-20
Catalog NumberMCP-100-30D-WW
Lot Number142698T
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerASCENSION ORTHOPEDICS
Manufacturer Address8700 CAMERON ROAD #100 8700 CAMERON ROAD #100 AUSTIN TX 78754 US 78754


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2015-09-25

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