FDA Adverse Event Malfunction Summary report: N

PROFEMUR(R) NECK EXTRACTOR T-HANDLE

MDR report key: 2072108 · Received April 28, 2011

Report

Report Number
1043534-2011-00168
Event Type
Malfunction
Date Received
April 28, 2011
Date of Event
March 15, 2011
Report Date
March 18, 2011
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
LXH
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

CONCLUSION: PRODUCT CONTRIBUTED TO EVENT.VISUALLY EXAMINED. COMPLAINT REVIEWED.

Additional Manufacturer Narrative · 1

THIS IS A REPORTABLE MALFUNCTION. THE INVESTIGATION IS NOT COMPLETE. ALTHOUGH SEVERAL ATTEMPTS HAVE BEEN MADE, NO MEDWATCH 3500A HAS BEEN RECEIVED FROM THE USER FACILITY. THIS REPORT WILL BE UPDATED WHEN THE INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

ALLEGEDLY THE INSTRUMENT STRIPPED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROFEMUR(R) NECK EXTRACTOR T-HANDLE HIP INSTRUMENT LXH WRIGHT MEDICAL TECHNOLOGY, INC. 345258

Patients

Seq Age Sex Outcome Treatment
1