FDA Adverse Event Injury Summary report: N

BOX CHISEL

MDR report key: 1815404 · Received August 19, 2010

Report

Report Number
2249697-2010-01116
Event Type
Injury
Date Received
August 19, 2010
Date of Event
July 21, 2010
Report Date
July 27, 2010
Manufacturer
STRYKER ORTHOPAEDICS MAHWAH
Product Code
KDG
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AN EVALUATION OF THE DEVICE CANNOT BE PERFORMED AS THE DEVICE WAS NOT RETURNED TO THE MANUFACTURER. IF DEVICE OR ADDITIONAL INFORMATION BECOMES AVAILABLE, THE EVALUATION SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

IT WAS REPORTED THAT, "REP WAS FOLLOWING UP WITH (B)(6) ON (B)(6) 2010 AND DR MENTIONED THAT HE NOTICED DURING THE PROCEDURE, WHILE CUTTING THE FEMORAL BOX, THAT THERE WAS A CRACK IN THE MEDIAL FEMORAL CONDYLE (BONE). THIS WAS NOT DUE TO THE IMPLANTS, OR ANY OTHER STRYKER PRODUCT. DR RELATED IT TO A SMALL FEMUR AND HARD BONE. DR SPOKE TO REP AND BOTH DECIDED TO REPORT THE INCIDENT, JUST TO GET IT ON RECORD. USED 6.5 PARTIALLY THREADED SCREW TO SECURE THE BONE AND IMPLANTED THE COMPONENTS IN A NORMAL FASHION."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BOX CHISEL INSTRUMENT KDG STRYKER ORTHOPAEDICS MAHWAH NA PYKJF

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention