FDA Adverse Event Malfunction Summary report: N

ADAPTER NUT

MDR report key: 2050579 · Received March 15, 2011

Report

Report Number
8031020-2011-00065
Event Type
Malfunction
Date Received
March 15, 2011
Date of Event
February 24, 2011
Report Date
February 25, 2011
Manufacturer
STRYKER OSTEOSYNTHESIS SELZACH
Product Code
LXH
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICES WILL NOT BE RETURNED. IF THE DEVICE OR ADD'L INFO IS RECEIVED; IT WILL BE SUBMITTED ON A SUPPLEMENTAL REPORT. ALSO INVOLVED IN THE EVENT IS CAT NO. 703522, PLATE ADAPTER DIST. LAT. FEMUR RIGHT LOT NO. K953115.

Description of Event or Problem · 1

IT WAS REPORTED, UPON REMOVAL OF TARGETING INSTRUMENTS, THE ADAPTER NUT CROSS THREADED IN THE PLATE ADAPTER. NO ACTION WAS NEEDED AS THE PLATE ADAPTER WAS LOOSE ENOUGH TO REMOVE FROM DIGITAL FEMUR PLATE AT CONCLUSION OF THE CASE. THE CASE FINISHED WITHOUT FURTHER ISSUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADAPTER NUT INSTRUMENT LXH STRYKER OSTEOSYNTHESIS SELZACH NA K873154

Patients

Seq Age Sex Outcome Treatment
1 UNK Other