FDA Adverse Event Malfunction Summary report: N

BENDING TEMPLATE RECONSTRUCTION PLATE 5 HOLES

MDR report key: 2724219 · Received August 28, 2012

Report

Report Number
8031020-2012-00197
Event Type
Malfunction
Date Received
August 28, 2012
Date of Event
August 8, 2012
Report Date
August 8, 2012
Manufacturer
STRYKER OSTEOSYNTHESIS SELZACH
Product Code
LXH
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

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

DURING SPS RECON PLATE SURGERY, THE SURGEON USED THE BENDING TEMPLATE THAT WAS NON-STERILE, W/O BEING STERILIZED. THE SURGEON HAD NOTICED THAT IT IS NON-STERILE WHILE USING THE BENDING TEMPLATE, HE WASHED THE WOUND OF PT AND SURGERY WAS COMPLETED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BENDING TEMPLATE RECONSTRUCTION PLATE 5 HOLES INSTRUMENT LXH STRYKER OSTEOSYNTHESIS SELZACH NA X22510

Patients

Seq Age Sex Outcome Treatment
1 UNK Other