FDA Adverse Event Malfunction Summary report: N

HANSSON PIN STST 110MM

MDR report key: 2050578 · Received March 15, 2011

Report

Report Number
8031020-2011-00066
Event Type
Malfunction
Date Received
March 15, 2011
Date of Event
February 14, 2011
Report Date
February 25, 2011
Manufacturer
STRYKER OSTEOSYNTHESIS SELZACH
Product Code
HTY
PMA / PMN Number
K033968
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADD'L INFO HAS BEEN REQUESTED. ONCE THE INVESTIGATION HAS BEEN COMPLETED; ANY ADD'L INFO WILL BE REPORTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

THE CUSTOMER REPORTS VIA OUR SALES REP, THAT THE THREAD WAS LOOSE AND THE LIP COULD NOT BE MOVED OUTWARDS. SHE FURTHER REPORTS THAT THE SURGERY WAS FINISHED WITH SLIGHT DELAY USING A DIFFERENT PIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HANSSON PIN STST 110MM IMPLANT HTY STRYKER OSTEOSYNTHESIS SELZACH NA S93287

Patients

Seq Age Sex Outcome Treatment
1 UNK Other