FDA Adverse Event Malfunction Summary report: N

QWIX CANNULATED DRILL FOR 7.5MM SCREWS

MDR report key: 1303818 · Received January 6, 2009

Report

Report Number
9615741-2008-00047
Event Type
Malfunction
Date Received
January 6, 2009
Date of Event
December 15, 2008
Report Date
January 5, 2009
Manufacturer
NEWDEAL S.A.
Product Code
HTW
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN RECEIVED FOR EVALUATION. AN INVESTIGATION HAS BEEN INITIATED BASED UPON THE REPORTED INFORMATION.

Description of Event or Problem · 1

THE REPORTER STATED THAT THE CANNULATED SCREW DRIVER BIT BROKE OFF IN THE PATIENT DURING A SUBTALAR FUSION PROCEDURE WHILE IMPLANTING A SCREW OVER THE 2.5MM K WIRE. THE FRAGMENT WAS LOCATED AND REMOVED AT THE TIME OF SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 QWIX CANNULATED DRILL FOR 7.5MM SCREWS CANNULATED DRILL FOR 7.5MM SCREWS HTW NEWDEAL S.A. EBJ1

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention