FDA Adverse Event Other Summary report: N

SCORPION SUTURE PASSER, 16MM

MDR report key: 1032958 · Received April 22, 2008

Report

Report Number
1220246-2008-00065
Event Type
Other
Date Received
April 22, 2008
Date of Event
March 12, 2008
Report Date
March 24, 2008
Manufacturer
ARTHREX, INC.
Product Code
GAB
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE EVAL CONFIRMED THE TIP HAD BROKEN. DEVICE HISTORY RECORD REVEALED NOTHING RELEVANT TO THIS EVENT. THIS DEVICE IS DESIGNED TO WITHSTAND FORCES UP TO 10 LBS, AND WHEN USED AS INTENDED, SHOULD NEVER SEE FORCES IN EXCESS OF DESIGN PARAMETERS. THIS EVENT WAS ATTRIBUTED TO MISUSE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE HOOK TIP OF THE INSTRUMENT BROKE OFF DURING A SHOULDER CUFF REPAIR. SURGEON REALIZED THE TIP WAS MISSING ONCE HE RETRIEVED THE INSTRUMENT FROM THE PT. THE TIP REMAINS IN THE PT. NO FURTHER PT INFO IS AVAILABLE AND NO ADD'L ADVERSE CONSEQUENCES WERE REPORTED FROM THIS EVENT. THIS DEVICE IS USED FOR TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SCORPION SUTURE PASSER, 16MM SUTURE PASSER GAB ARTHREX, INC. NA 10286

Patients

Seq Age Sex Outcome Treatment
1 UNK Other