FDA Adverse Event Malfunction Summary report: N

DRILL, AO, STERILE 4,2X180 MM

MDR report key: 1958591 · Received December 16, 2010

Report

Report Number
9610622-2010-00572
Event Type
Malfunction
Date Received
December 16, 2010
Date of Event
December 13, 2010
Report Date
December 13, 2010
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
HBE
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

DEVICE WILL NOT BE RETURNED. IF THE DEVICE OR ADD'L INFO IS REC'D, IT WILL BE REPORTED ON A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

THE NURSE FROM THE HOSPITAL REPORTED BY PHONE TO THE QA MANAGER FROM STRYKER (B)(6), THE ALLEGE EVENT. THE LABEL ON THE DEVICE WAS NOT CORRECT. THE CATALOG NUMBER ON THE DRILL WAS LABELED W/O AN "S" WHICH WOULD INDICATE THAT THE DEVICE WAS NOT STERILE. THE DEVICE SHOULD BE STERILE AND SHOULD HAVE AN S.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DRILL, AO, STERILE 4,2X180 MM INSTRUMENT HBE STRYKER OSTEOSYNTHESIS KIEL NA K185590

Patients

Seq Age Sex Outcome Treatment
1 UNK Other