FDA Adverse Event Malfunction Summary report: N

2.0MM ASNIS MICRO, CANNULATED SCREWDRIVER, 2.0MM

MDR report key: 1960339 · Received December 16, 2010

Report

Report Number
8010177-2010-00469
Event Type
Malfunction
Date Received
December 16, 2010
Date of Event
November 20, 2010
Report Date
November 23, 2010
Manufacturer
STRYKER OSTEOSYNTHESIS FREIBURG
Product Code
LXH
PMA / PMN Number
EXEMPT
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FI
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

BASED ON INVESTIGATION THE FAILURE OF THE BLADE (FRACTURED TIP) WAS CAUSED BY THE ACTION OF TOO HIGH TORSIONAL AND BENDING FORCES. INDICATIONS FOR MATERIAL OR MANUFACTURING RELATED PROBLEMS WERE NOT FOUND IN THE INVESTIGATION.

Description of Event or Problem · 1

NURSE INFORMED SALES REP THAT TIP OF THE SCREWDRIVER GOT BROKEN DURING OPERATION. PART OF THE SCREWDRIVER TIP IS ATTACHED TO THE IMPLANTED SCREW.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 2.0MM ASNIS MICRO, CANNULATED SCREWDRIVER, 2.0MM INSTRUMENT LXH STRYKER OSTEOSYNTHESIS FREIBURG NA Z1-01/2009

Patients

Seq Age Sex Outcome Treatment
1 31 YR