FDA Adverse Event Malfunction Summary report: N

FOOTED ATTACHMENT 2.4MM LEGEND, AF02 (B-1)

MDR report key: 1317073 · Received January 9, 2009

Report

Report Number
1625507-2009-00002
Event Type
Malfunction
Date Received
January 9, 2009
Report Date
December 12, 2008
Manufacturer
MEDTRONIC POWERED SURGICAL SOLUTIONS
Product Code
HBB
PMA / PMN Number
K020069
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

COMMENTS: REPORT CONFIRMED ON EVAL. THE FOOTED PORTION WAS CUT AND DETACHED. NO ADD'L INFO WAS AVAILABLE ON F/U. OUR RECOMMENDATION FOR FACTORY SERVICE IS BASED ON THE FACILITY'S USAGE, HOWEVER, IT SHOULD NOT EXCEED 24 MONTHS. THIS DEVICE HAS BEEN IN USE FOR 30 MONTHS WITHOUT ANY RECORD OF FACTORY SERVICE. THE USER MANUAL CONTAINS THE FOLLOWING WARNING "THE ATTACHMENT SHOULD NOT BE USED IF ANY PART OF THE ATTACHMENT APPEARS TO BE BENT, LOOSE, MISSING, OR DAMAGED. EXCESSIVE PRESSURE OR IMPROPER HANDLING, SUCH AS BENDING OR PRYING, OF THE ATTACHMENT OR DISSECTING TOOL MAY CAUSE INJURY TO THE PT, OPERATOR AND/OR OPERATING ROOM STAFF."

Description of Event or Problem · 1

REPAIR REQUEST INITIATED AND ESCALATED TO COMPLAINT FOR DEVICE WITH A REPORT OF A CUT FOOT. NO PT IMPACT REPORTED. NO ADD'L INFO WAS AVAILABLE ON F/U.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FOOTED ATTACHMENT 2.4MM LEGEND, AF02 (B-1) PNEUMATIC SURG DRILL ATTACHMENT LEGEND HBB MEDTRONIC POWERED SURGICAL SOLUTIONS NA NA

Patients

Seq Age Sex Outcome Treatment
1