FDA Adverse Event Malfunction Summary report: N

*

MDR report key: 1971156 · Received January 18, 2011

Report

Report Number
1971156
Event Type
Malfunction
Date Received
January 18, 2011
Date of Event
January 3, 2011
Report Date
January 18, 2011
Manufacturer
THE ANSPACH EFFORT
Product Code
HBF
Product Problem
Yes
Report Source
User Facility report
Reporter Location
CA, US

Narratives

Description of Event or Problem · 1

DR. PERFORMING CRANIAL FLAP WITH THE DRILL, IT WAS NOTED BY DR. THAT THE DISTAL END OF THE DRILL BIT WAS MISSING. DR. IMMEDIATELY SEARCHED THE WOUND AND LOCATED THE MISSING PIECE. THE 2 PIECES WERE SEQUESTERED FOR FOLLOW-UP AFTER THE CASE. THE MISSING PIECE MEASURED 5MM IN LENGTH. THE 2 PIECES WERE PLACED IN A BIOHAZARD BAG AND KEPT FOR FOLLOW UP WITH ANSPACH. THE ANSPACH REP WAS INFORMED OF THE INCIDENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 * DRILLS, BURRS, TREPHINES & ACCESSORIES (COMPOUND, POWERED) HBF THE ANSPACH EFFORT * *

Patients

Seq Age Sex Outcome Treatment
1 60 YR NO OTHER THERAPIES