FDA Adverse Event Malfunction Summary report: N

LINXHT CALIBRATED PASSER PIN, 2.4MM

MDR report key: 1693715 · Received May 10, 2010

Report

Report Number
1221934-2010-00183
Event Type
Malfunction
Date Received
May 10, 2010
Date of Event
April 27, 2010
Report Date
April 27, 2010
Manufacturer
DEPUY MITEK
Product Code
NBH
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

MITEK IS AT THIS POINT IN TIME IN THE INFO GATHERING MODE. WHEN ALL THAT CAN BE HAD, IS HAD AND THOROUGHLY INVESTIGATED AND EVALUATED, THOSE RESULTS WILL BE THE SUBJECT MATTER IN A FOLLOW-UP REPORT.

Description of Event or Problem · 1

OUR REP IS REPORTING TO US THAT DURING AN ARTHROSCOPIC KNEE REPAIR, THE TIPS OF 4 PASSER PINS BROKE OFF INTO THE BONE. ALL OF THE FRAGMENTS WERE RETRIEVED FROM THE BODY AND THE PROCEDURE WAS CONCLUDED SUCCESSFULLY WITHOUT FURTHER ISSUE OR HARM TO THE PT. COMPLAINT DEVICES DISCARDED BY USER FACILITY. ALSO SEE ASSOCIATED MDRS 1221934-2010-00184, 1221934-2010-00185 AND 1221934-2010-00186.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LINXHT CALIBRATED PASSER PIN, 2.4MM ARTHROSCOPIC INSTRUMENT NBH DEPUY MITEK 254728 0907529

Patients

Seq Age Sex Outcome Treatment
1 UNK