FDA Adverse Event Other Summary report: N

HYDROSET ORTHO 5CC

MDR report key: 1613194 · Received February 8, 2010

Report

Report Number
8010177-2010-00061
Event Type
Other
Date Received
February 8, 2010
Date of Event
September 29, 2008
Report Date
September 29, 2008
Manufacturer
STRYKER ORTHOPAEDICS LIMERICK
Product Code
GXP
PMA / PMN Number
K060763
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ROOT CAUSE UNK. POSSIBLE ROOT CAUSES: PARTS OF POWDER AND/OR LIQUID WERE LOST DURING MIXING PROCESS; OPERATING ROOM TEMPERATURE WITHOUT IFU SPECIFICATION (18-22C); PRODUCT TEMPERATURE OUT OF IFU SPECIFICATION. THE IFU CONTAINS DETAILED INFO TO MIX AND IMPLEMENT HYDROSET.

Description of Event or Problem · 1

SURGEON WAS APPLYING HYDROSET AND AS HE WAS APPLYING, PRODUCT BEGAN TO SLOWLY LOOK LIKE COTTAGE CHEESE. SURGEON TRIED TO SUCTION AROUND THE AREA, BUT THE PRODUCT JUST CRUMBLED. SURGEON DECIDED TO TAKE HYDROSET OUT OF PT, IRRIGATED, AND FINISHED SURGERY WITHOUT HYDROSET.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HYDROSET ORTHO 5CC IMPLANT GXP STRYKER ORTHOPAEDICS LIMERICK NA H75FC002

Patients

Seq Age Sex Outcome Treatment
1 71 YR