FDA Adverse Event Malfunction Summary report: N

CONFIDENCE INTRODUCER NEEDLE, DIAMOND, 13G 4"

MDR report key: 1396821 · Received March 12, 2009

Report

Report Number
1526439-2009-00045
Event Type
Malfunction
Date Received
March 12, 2009
Date of Event
February 17, 2009
Manufacturer
DEPUY SPINE, INC.
Product Code
GAA
PMA / PMN Number
EXEMPT
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NO CONCLUSION CAN BE MADE. THE BROKEN NEEDLE IS NOT AVAILABLE FOR EVAL. REVIEW OF THE DEVICE HISTORY RECORD CONFIRMED THE LOT MET SPEC REQUIREMENTS WHEN RELEASED TO STOCK. NO OTHER PRODUCT COMPLAINTS HAVE BEEN REPORTED FOR THIS ITEM. AT THIS TIME, THE COMPLAINT IS CONSIDERED TO BE CLOSED.

Description of Event or Problem · 1

INTERNATIONAL AFFILIATE REPORTS THE TIP OF THE INTRODUCER NEEDLE BROKE OFF WHEN INSERTED DURING A VERTEBRAL BODY AUGMENTATION PROCEDURE. THE BROKEN TIP REMAINS IN THE PT'S PEDICLE. THE REMAINING SECTION OF THE NEEDLE WAS DISCARDED BY THE CUSTOMER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CONFIDENCE INTRODUCER NEEDLE, DIAMOND, 13G 4" INTRODUCER NEEDLE GAA DEPUY SPINE, INC. NA CJPCBZ

Patients

Seq Age Sex Outcome Treatment
1 UNK