BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDTRONIC

    MDR report key: 1701726 · Received May 24, 2010

    Report

    Report Number
    MW5016088
    Event Type
    Malfunction
    Date Received
    May 24, 2010
    Date of Event
    March 15, 2010
    Report Date
    May 24, 2010
    Manufacturer
    MEDTRONIC
    Product Code
    LXH
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    TIP OF A MEDTRONIC 3D PEDICLE PROBE BROKE IN THE PT'S VERTEBRAL BODY OF THE LEFT L 5 PEDICLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC PEDICLE PROBE LXH MEDTRONIC 836-034 BM517784

    Patients

    Seq Age Sex Outcome Treatment
    1 58 YR