FDA Adverse Event Malfunction Summary report: N

SET SCREWDRIVER BIT 4X190 MM

MDR report key: 1078935 · Received July 16, 2008

Report

Report Number
9610622-2008-00120
Event Type
Malfunction
Date Received
July 16, 2008
Date of Event
June 20, 2008
Report Date
June 24, 2008
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
HXX
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED. NO EVALUATION WILL BE SUBMITTED. IF THE DEVICE OR ADDITIONAL INFORMATION BECOMES AVAILABLE IT WILL BE REPORTED ON A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

THE RISK MANAGER FROM THE HOSPITAL, REPORTED THE FOLLOWING EVENT: DURING SURGERY, THE SURGEON SCREWED THE SCREW REF. 12060822S LOT K694400 WITH THE SCREWDRIVER. THE SURGEON DIDN'T HEAR THE "CLICK" AS USUAL AND HAD DIFFICULTIES REMOVING THE SCREWDRIVER FROM THE SCREW HEAD. DURING THE CLEANING AND STERILIZATION, IT WAS NOTICED THAT THE TIP OF THE SCREWDRIVER WAS MISSING. THE SURGEON ASSUMED THAT THE TIP REMAINED IN THE SCREW HEAD WHICH WAS IMPLANTED IN THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SET SCREWDRIVER BIT 4X190 MM INSTRUMENT HXX STRYKER OSTEOSYNTHESIS KIEL NA K743842

Patients

Seq Age Sex Outcome Treatment
1 UNK Other