FDA Adverse Event Malfunction Summary report: N

IM REAMER, AO FITTING 10,5X480 MM

MDR report key: 2088814 · Received May 4, 2011

Report

Report Number
9610622-2011-00198
Event Type
Malfunction
Date Received
May 4, 2011
Date of Event
April 18, 2011
Report Date
April 18, 2011
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
LXH
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KU
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. ADD'L LOT#: K227142.

Description of Event or Problem · 1

THE DISTRIBUTOR REPORTED THAT THE OUTER METALLIC LAYER OF ALL THREE REAMERS GOT BENT AND BULGED TO OUT SIDE. A PT WAS INVOLVED AND THE SURGEON CHANGED THE REAMER AND CONTINUED THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 IM REAMER, AO FITTING 10,5X480 MM INSTRUMENT LXH STRYKER OSTEOSYNTHESIS KIEL NA K125967

Patients

Seq Age Sex Outcome Treatment
1 UNK Other