FDA Adverse Event Other Summary report: N

COLD KNIFE, STRAIGHT BLADE, 3/PKG

MDR report key: 1981377 · Received February 3, 2011

Report

Report Number
3006159227-2011-00001
Event Type
Other
Date Received
February 3, 2011
Date of Event
January 3, 2011
Report Date
February 3, 2011
Manufacturer
GYRUS ACMI, INC
Product Code
GDX
PMA / PMN Number
PREAMEND
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

PERFORMANCE REPORT, NO DEVICE IS BEING RETURNED; THEREFORE WE CANNOT DETERMINE THE FAILURE MODE OF THE REPORTED INCIDENT. WE WILL MONITOR THE COMPLAINT DATABASE FOR FURTHER OCCURRENCES. IF FURTHER INFO BECOMES AVAILABLE, GYRUS (B)(4) WILL CONTINUE THE INVESTIGATION AND UPDATE THE AGENCY ACCORDINGLY.

Description of Event or Problem · 1

DURING A SURGICAL PROCEDURE WHILE USING THE ELITE COLD KNIFE STRAIGHT BLADE, THE BLADE BROKE OFF IN THE PT. THE SURGEON WAS ABLE TO RETRIEVE THE BLADE WITHOUT HARMING THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COLD KNIFE, STRAIGHT BLADE, 3/PKG COLD KNIFE, STRAIGHT BLADE, 3/PKG GDX GYRUS ACMI, INC K-SB UNK

Patients

Seq Age Sex Outcome Treatment
1