FDA Adverse Event Malfunction Summary report: N

MANUAL ORTHOPEDIC SURGICAL INSTRUMENT

MDR report key: 1063018 · Received June 19, 2008

Report

Report Number
1030489-2008-00287
Event Type
Malfunction
Date Received
June 19, 2008
Report Date
May 20, 2008
Manufacturer
MEDTRONIC SOFAMOR DANEK
Product Code
LXH
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN RETURNED TO MEDTRONIC FOR EVALUATION. A REVIEW OF THE DEVICE HISTORY RECORDS FOUND NO DOCUMENTATION TO INDICATE A NON-CONFORMANCE TO SPECIFICATION. UNABLE TO DETERMINE CAUSE OF THE EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE 2MM PITUITARY TIP WAS BROKEN OFF DURING USE IN SURGERY. NO PATIENT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MANUAL ORTHOPEDIC SURGICAL INSTRUMENT PITUITARY LXH MEDTRONIC SOFAMOR DANEK NA GZ06A058

Patients

Seq Age Sex Outcome Treatment
1 UNK