FDA Adverse Event Malfunction Summary report: N

45 LEFT DISPOSABLE SUTURE SLIDER WITH NITINOL LOO

MDR report key: 1024223 · Received March 27, 2008

Report

Report Number
2936485-2008-00017
Event Type
Malfunction
Date Received
March 27, 2008
Date of Event
February 25, 2008
Report Date
February 28, 2008
Manufacturer
STRYKER ENDOSCOPY SAN JOSE
Product Code
GDF
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

A FOLLOW-UP REPORT WILL BE SUBMITTED UPON COMPLETION OF THE COMPLAINT INVESTIGATION.

Description of Event or Problem · 1

DURING A SURGERY PROCEDURE, THE SURGEON NOTED THAT THE TIP OF THE SUTURE SLIDER BROKE OFF. THE SURGEON TRIED TO REMOVE ALL BROKEN PIECES. AS PARTS OF THE TIP STILL REMAIN IN THE PATIENT, A REVISION SURGERY BECAME NECESSARY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 45 LEFT DISPOSABLE SUTURE SLIDER WITH NITINOL LOO SUTURE SLIDER GDF STRYKER ENDOSCOPY SAN JOSE 05256AG2

Patients

Seq Age Sex Outcome Treatment
1 UNK