FDA Adverse Event Other Summary report: N

ULTRA 360 PATIENT POSITIONING SYSTEM

MDR report key: 1404116 · Received June 16, 2009

Report

Report Number
3004608878-2009-00026
Event Type
Other
Date Received
June 16, 2009
Report Date
June 16, 2009
Product Code
FWZ
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS BEEN RECEIVED FOR EVALUATION. AN INVESTIGATION HAS BEEN INITIATED BASED UPON THE REPORTED INFORMATION. THE INVESTIGATION WILL INCLUDE AN INSPECTION AND TESTING OF THE RETURNED DEVICE.

Description of Event or Problem · 1

THE REPORTER STATED, MAYFIELD 360 BASE UNIT DOES NOT THREAD INTO THE CRWMA ADAPTOR WITHOUT BECOMING STUCK. ON (B)(6), 2009, SECONDARY REPORTER STATED, THE EVENT RESULTED IN A 45 MINUTE TO AN HOUR DELAY IN TWO SEPARATE PATIENT SURGICAL PROCEDURES. THE EVENT OCCURRED DURING TWO SEPARATE STEREOTACTIC BRAIN BIOPSY PROCEDURES. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ULTRA 360 PATIENT POSITIONING SYSTEM NA FWZ

Patients

Seq Age Sex Outcome Treatment
1