BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MPR WING RETRACTOR

    MDR report key: 10075675 · Received May 19, 2020

    Report

    Report Number
    MW5094610
    Event Type
    Injury
    Date Received
    May 19, 2020
    Date of Event
    September 16, 2019
    Report Date
    May 15, 2020
    Manufacturer
    UNK
    Product Code
    GAD
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE TIP (PIN) OF THE SUPERIOR ACETABULAR PLACED DIAMOND WING RETRACTOR BROKE OFF IN THE PATIENT'S PELVIC BONE. TIP WAS LEFT IN SITU DUE TO RISKS OF RETRIEVAL VS LOW POTENTIAL FOR COMPLICATIONS IF LEFT IN PLACE. PLACEMENT CONFIRMED VIA IMAGING AND PATIENT HAS BEEN EDUCATED. MEDICAL PRODUCTS RESOURCE, US. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    532052 MPR WING RETRACTOR RETRACTOR GAD UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Disability