FDA Adverse Event Malfunction Summary report: N

MAYFIELD TRIAD SKULL CLAMP

MDR report key: 2151408 · Received June 21, 2011

Report

Report Number
3004608878-2011-00081
Event Type
Malfunction
Date Received
June 21, 2011
Report Date
June 21, 2011
Manufacturer
INTEGRA, CINCINNATI
Product Code
HBL
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN RECEIVED FOR EVAL. AN INVESTIGATION HAS BEEN INITIATED BASED ON THE REPORTED INFO.

Description of Event or Problem · 1

A NEW TRIAD SKULL CLAMPS' SWIVEL ADAPTOR WOULD NOT LOCK. THE STAFF ATTEMPTED TO APPLY THE UNIT TO THE PT WHEN THE PROBLEM WAS FOUND. IT IS UNK WHETHER THE PT INCURRED AN INJURY AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MAYFIELD TRIAD SKULL CLAMP SKULL CLAMPS AND HEADREST SYSTEMS HBL INTEGRA, CINCINNATI

Patients

Seq Age Sex Outcome Treatment
1