FDA Adverse Event Malfunction Summary report: N

SEQUOIA FINAL DRIVER (PLE)

MDR report key: 2182856 · Received July 8, 2011

Report

Report Number
1649384-2011-00047
Event Type
Malfunction
Date Received
July 8, 2011
Date of Event
June 9, 2011
Report Date
June 9, 2011
Manufacturer
ZIMMER SPINE
Product Code
NKB
Removal / Correction Number
1649384-02/28/2011-001C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

VISUAL EVALUATION OF THE RETURNED DEVICE REVEALED ROUNDED CORNERS ON THE HEX TIP. A FIELD ACTION, 1649384-02/28/2011-001-C, TO INFORM USERS TO ENSURE COMPLETE INSTRUMENT ENGAGEMENT WITH THE CLOSURE TOP AND MAINTAIN ON AXIS USE DURING FINAL TIGHTENING HAS BEEN INITIATED. THIS IS THE FINAL REPORT THAT WILL SUBMITTED FOR THIS DEVICE.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A SURGERY, BOTH DRIVERS IN THE KIT WERE ROUNDED AND THE CLOSURE TOPS COULD NOT BE PROPERLY FINAL TIGHTENED. THERE WAS NO DELAY TO THE CASE AND NO IMPACT ON THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SEQUOIA FINAL DRIVER (PLE) FINAL DRIVER NKB ZIMMER SPINE 3384-2 60LL

Patients

Seq Age Sex Outcome Treatment
1