FDA Adverse Event Malfunction Summary report: N

5.0MM BIOZIP SUT ANCHOR W/ 2 #2 FORCE FIBER SUTURE

MDR report key: 1060990 · Received June 12, 2008

Report

Report Number
2936485-2008-00051
Event Type
Malfunction
Date Received
June 12, 2008
Date of Event
May 14, 2008
Report Date
May 16, 2008
Manufacturer
STRYKER ENDOSCOPY
Product Code
KGS
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFO WILL BE PROVIDED, ONCE INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

IT WAS REPORTED THAT, "THE SURGEON USED A 5.0 BIOZIP ANCHOR ON THE LEFT SHOULDER FOR A ROTATOR CUFF SUPRASPINATUS TEAR. THE SUTURE (FORCE FIBER) BROKE. THE SURGEON BACKED OUT THE ANCHOR USING THE ORIGINAL TROCAR TIP INSERTER. HE THEN WENT IN WITH A 6.5 BIOZIP. WHEN HE WAS TYING HIS KNOTS ARTHROSCOPICALLY, THE ANCHOR EYELETS BROKE. HE THEN BACKED OUT OF 6.5. HE TRIED TO USE AN "ARTHRY" BIOCOCK SCREW AND IT PULLED OUT. SO HE DID A MINI-OPEN PROCEDURE AND INSERT ANOTHER BIOCOCKSCREW."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 5.0MM BIOZIP SUT ANCHOR W/ 2 #2 FORCE FIBER SUTURE FIBER SUTURE KGS STRYKER ENDOSCOPY 3602268

Patients

Seq Age Sex Outcome Treatment
1 54 YR