FDA Adverse Event Injury Summary report: N

DORO® SKULL CLAMP RADIOLUCENT

MDR report key: 14216706 · Received April 27, 2022

Report

Report Number
3003923584-2022-00006
Event Type
Injury
Date Received
April 27, 2022
Date of Event
March 29, 2022
Report Date
April 1, 2022
Manufacturer
PRO MED INSTRUMENTS GMBH
Product Code
HBL
UDI-DI
04250435502181
PMA / PMN Number
K032331
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE CUSTOMER HAS NOT YET SENT THE PRODUCT IN FOR INVESTIGATION. WE WILL PERFORM A FOLLOW-UP AS SOON AS THE PRODUCT HAS ARRIVED AND THE FINDINGS HAVE BEEN COMPLETED.

Additional Manufacturer Narrative · 0

AS THE DEVICE IS IN SPECIFICATION AND DID NOT SHOW ANY DEVIATION THAT COULD CAUSE THE REPORTED INCIDENT WE SUSPECT, THAT MAYBE THE PINNING TECHNIQUE HAS BEEN NOT OPTIMAL AS DESCRIBED IN THE INSTRUCTION MANUAL: "ADJUST THE SKULL CLAMP TO THE WIDTH OF THE PATIENT'S HEAD IN THE MANNER THAT THE TWO SKULL PINS IN THE ROCKER ARM ARE EQUIDISTANT FROM THE CENTERLINE OF THE HEAD AND THE SINGLE SKULL PIN AT THE EXTENSION ASSEMBLY IS IN LINE WITH THIS CENTERLINE." WE RECOMMEND USING OUR SKULL PINS IN COMBINATION WITH OUR SKULL CLAMPS. RISKS DUE TO NOT PERMITTED SYSTEM COMBINATIONS WITH THIRD PARTY COMPONENTS COULD NOT BE EXCLUDED, AS IN THIS CASE.

Description of Event or Problem · 0

CUSTOMER INFORMED OUR SERVICE DEPARTMENT ON THE 1ST OF APRIL THAT ONE OF OUR PRODUCTS WAS INVOLVED IN A CASE WHERE A LACERATION OCCURED.

Description of Event or Problem · 0

NO FURTHER DESCRIPTION FOR THIS FOLLOW-UP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1479389 DORO® SKULL CLAMP RADIOLUCENT DORO® SKULL CLAMP RADIOLUCENT HBL PRO MED INSTRUMENTS GMBH 3034-00 04250435502181

Patients

Seq Age Sex Outcome Treatment
1 Unknown Other