FDA Adverse Event Malfunction Summary report: N

TRINICA CERVICAL PLATE SYSTEM

MDR report key: 1082180 · Received July 22, 2008

Report

Report Number
2184052-2008-00020
Event Type
Malfunction
Date Received
July 22, 2008
Date of Event
June 25, 2008
Report Date
June 26, 2008
Manufacturer
ZIMMER SPINE, INC.
Product Code
LXH
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

DIMENSIONAL ANALYSIS AND REVIEW OF THE BATCH RECORDS: DIMENSIONAL ANALYSIS DID NOT REVEAL ANY DISCREPANCIES. BATCH RECORD REVIEW CONCLUDED THAT THE DEVICE WAS MANUFACTURED TO ALL APPLICABLE SPECS.

Description of Event or Problem · 1

DURING SURGERY ONE DRILL GUIDE TUBE DETACHED FROM THE INSTRUMENT. THE BROKEN PIECE WAS RETRIEVED. SURGERY WAS SUCCESSFULLY COMPLETED WITH NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRINICA CERVICAL PLATE SYSTEM ATO VARIABLE DRILL GUIDE LXH ZIMMER SPINE, INC. 07.00782.001 P040131

Patients

Seq Age Sex Outcome Treatment
1 60 YR Other