FDA Adverse Event Malfunction Summary report: N

SIZE 4-8 KEEL PUNCH GUIDE

MDR report key: 2369161 · Received November 9, 2011

Report

Report Number
2249697-2011-01567
Event Type
Malfunction
Date Received
November 9, 2011
Date of Event
October 11, 2011
Report Date
October 13, 2011
Manufacturer
STRYKER ORTHOPAEDICS MAHWAH
Product Code
LXH
PMA / PMN Number
NA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SW
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

WHEN COMPLETED, THE EVAL SUMMARY WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

THE SURGERY NURSE (B)(6) HAS REPORTED TO THE SALES REP PER OLOF BRETTMAR THAT THE POSTERIOR LOCKING PART CAME LOSS FROM INSTRUMENT DURING IMPACTION OF KIL PREPARATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SIZE 4-8 KEEL PUNCH GUIDE INSTRUMENT LXH STRYKER ORTHOPAEDICS MAHWAH NA NYC01

Patients

Seq Age Sex Outcome Treatment
1 UNK Other