FDA Adverse Event Other Summary report: N

BIO-PUSHLOCK 4.5MM X 18.5MM

MDR report key: 1001409 · Received February 20, 2008

Report

Report Number
1220246-2008-00030
Event Type
Other
Date Received
February 20, 2008
Date of Event
January 31, 2008
Report Date
January 31, 2008
Manufacturer
ARTHREX, INC.
Product Code
MAI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS EXPECTED FOR EVALUATION BUT HAS NOT YET BEEN RECEIVED. A FOLLOW UP REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A ROTATOR CUFF PROCEDURE (RIGHT SHOULDER) THE PEEK EYELETS DETACHED FROM THE DEVICE. THE SURGEON HAD PLACED 4 STRANDS OF SUTURE AND AFTER TAPPING DOWN THE PUSHLOCK, HE HEARD A POP. WHEN THE DEVICE WAS PULLED OUT, THE EYELET HAD COME OUT (X2). SURGEON USED A THIRD ONE FROM A DIFFERENT LOT, DEEPER INTO THE BONE AND COMPLETED THE CASE SUCCESSFULLY. NO FURTHER PT INFO IS AVAILABLE FROM CUSTOMER. THIS DEVICE IS USED FOR TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BIO-PUSHLOCK 4.5MM X 18.5MM BIO-ABSORBABLE IMPLANT MAI ARTHREX, INC. NA 142185

Patients

Seq Age Sex Outcome Treatment
1 54 YR Other