FDA Adverse Event Malfunction Summary report: N

FIXATION BOLT 9X50 MM

MDR report key: 2472153 · Received February 23, 2012

Report

Report Number
9610622-2012-00101
Event Type
Malfunction
Date Received
February 23, 2012
Date of Event
February 15, 2012
Report Date
February 15, 2012
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
LXH
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ONCE THE INVESTIGATION HAS BEEN COMPLETED ANY ADD'L INFO WILL BE REPORTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

ON (B)(6) 2012, GAMMA3 LONG NAIL OPERATION WAS PERFORMED. WHEN ASSEMBLING THE GAMMA3 TARGET DEVICE AND DTD, FIXATION BOLT COULDN'T BE INSERTED. SURGEON TRIED ANOTHER BOLT, THEN THE ANOTHER BOLT COULD BE INSERTED. AFTER THE OPERATION SALES REP TRIED TO INSERT THE BOLT WHICH FAILED DURING THE OPERATION, THE BOLT COULD BE INSERTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FIXATION BOLT 9X50 MM INSTRUMENT LXH STRYKER OSTEOSYNTHESIS KIEL NA K283813

Patients

Seq Age Sex Outcome Treatment
1 UNK Other