FDA Adverse Event Malfunction Summary report: N

STEALTHSTATION TREON TREATMENT GUIDANCE SYSTEM

MDR report key: 2193494 · Received July 21, 2011

Report

Report Number
1723170-2011-01236
Event Type
Malfunction
Date Received
July 21, 2011
Date of Event
July 6, 2011
Report Date
July 6, 2011
Manufacturer
MEDTRONIC NAVIGATION, INC.
Product Code
HAW
PMA / PMN Number
K050438
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

NO PT INFO PROVIDED AS NO PT WAS INVOLVED IN THIS CONCERN. RMA ISSUED FOR TWO REPLACEMENT VERTEK II ARMS, BOTH SHIPPED ON (B)(4) 2011. INVESTIGATION FINDS FIRST VERTEK ARM HANDLE HAD BEEN TURNED TOO FAR OPEN AND WAS LOCKED UP. MEDTRONIC REP WAS ABLE TO BREAK THE HANDLE LOOSE, BUT BOTH ENDS OF THE VERTEK ARE LOCKED UP; AND THE TIP OF THE ATTACHMENT SCREW IS BROKEN OFF. SECOND RETURNED PART, FOUND BOTH ENDS OF THE VERTEK LOCK AND RELEASE WITH THE HANDLE. NO VISIBLE DAMAGE. NO PROBLEM FOUND. SECOND VERTEK ARM IS FULLY FUNCTIONAL.

Description of Event or Problem · 1

A SITE PURCHASING REP REPORTED TWO DAMAGED VERTEK ARMS IN NEED OF REPLACEMENT. THIS EVENT DID NOT OCCUR DURING SURGERY AND NO PT WAS PRESENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STEALTHSTATION TREON TREATMENT GUIDANCE SYSTEM STEREOTAXIC INSTRUMENT HAW MEDTRONIC NAVIGATION, INC. TREON NA

Patients

Seq Age Sex Outcome Treatment
1