BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SGL TRIG PIN COLLET 2.0-3.2MM

    MDR report key: 1902896 · Received November 12, 2010

    Report

    Report Number
    1811755-2010-01687
    Event Type
    Malfunction
    Date Received
    November 12, 2010
    Date of Event
    October 27, 2010
    Report Date
    October 27, 2010
    Manufacturer
    STRYKER INSTRUMENTS KALAMAZOO
    Product Code
    KIJ
    PMA / PMN Number
    K972367
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE WAS RETURNED TO THE MFR FOR INVESTIGATION. BASED ON THE QUALITY INVESTIGATION, THE IMPREGLON COATING ON THE DEVICE WAS WORN OFF. THIS CONDITION COULD CAUSE THE DEVICE TO STICK, AND NOT ALLOW THE COLLET TO RELEASE THE PIN.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE DEVICE HAD A PIN STUCK IN IT DURING A PROCEDURE. THE PROCEDURE WAS COMPLETED AS PLANNED WITH NO ALLEGATION OF ADVERSE CONSEQUENCES ASSOCIATED WITH THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SGL TRIG PIN COLLET 2.0-3.2MM INSTRUMENT, SURGICAL, ORTHOPEDIC, DC-POWERED MOTOR KIJ STRYKER INSTRUMENTS KALAMAZOO

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK