FDA Adverse Event Injury Summary report: N

STEALTHSTATION TREON TREATMENT GUIDANCE SYSTEM

MDR report key: 1910584 · Received November 19, 2010

Report

Report Number
1723170-2010-00067
Event Type
Injury
Date Received
November 19, 2010
Date of Event
October 21, 2010
Report Date
October 21, 2010
Manufacturer
MEDTRONIC NAVIGATION
Product Code
HAW
PMA / PMN Number
K050438
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE SYSTEM WAS EVALUATED AT THE SITE. THE REPORTED ISSUE WAS NOT ABLE TO BE DUPLICATED BY A MEDTRONIC REPRESENTATIVE. THE SYSTEM WAS FULLY FUNCTIONAL AND THE SYSTEM CHECKOUT SHOWED NO ANOMALIES.

Description of Event or Problem · 1

MEDTRONIC REPRESENTATIVE REPORTED THAT A PT HAD THE L5 RIGHT SCREW NOT INSERTED CORRECTLY AND REQUIRED A REVISION. SITE REPRESENTATIVE REPORTED THAT IT WAS NOT AN ISSUE WITH NAVIGATION, BUT WITH THE PLACEMENT OF THE SCREW. REVISION SURGERY COMPLETED WITHOUT ISSUE. PT REPORTED TO BE DOING GREAT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STEALTHSTATION TREON TREATMENT GUIDANCE SYSTEM STEREOTAXIC INSTRUMENT (HAW) HAW MEDTRONIC NAVIGATION TREON NA

Patients

Seq Age Sex Outcome Treatment
1 49 YR Required Intervention