FDA Adverse Event Malfunction Summary report: N

BIPASS DISPOSABLE NITINOL

MDR report key: 1629070 · Received March 11, 2010

Report

Report Number
1825034-2010-00082
Event Type
Malfunction
Date Received
March 11, 2010
Date of Event
February 3, 2010
Report Date
February 17, 2010
Manufacturer
BIOMET SPORTS MEDICINE
Product Code
HXO
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

EVALUATION IN PROCESS BUT NOT YET COMPLETE. UPON COMPLETION OF EVALUATION, A FOLLOW UP REPORT WILL BE SENT TO THE FDA. THIS REPORT FILED (B)(6) 2010.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT A ROTATOR CUFF REPAIR PROCEDURE UTILIZING A SUTURE PASSER ON (B)(6) 2010. DURING THE PROCEDURE, THE SURGEON MADE UNSUCCESSFUL ATTEMPTS TO PASS THE SUTURE THROUGH THE ROTATOR CUFF. THE TIP OF THE NITINOL WIRE FRACTURED BUT COULD NOT BE LOCATED. SURGEON SEARCHED THE JOINT SPACE HOWEVER, NO RADIOGRAPHS WERE TAKEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BIPASS DISPOSABLE NITINOL PUSHER HXO BIOMET SPORTS MEDICINE N/A 592170

Patients

Seq Age Sex Outcome Treatment
1