FDA Adverse Event Malfunction Summary report: N

TARGET DEVICE T2 GTN

MDR report key: 2823905 · Received October 10, 2012

Report

Report Number
9610622-2012-00449
Event Type
Malfunction
Date Received
October 10, 2012
Date of Event
September 19, 2012
Report Date
September 19, 2012
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
LXH
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
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

IT WAS REPORTED THAT AFTER SURGERY WAS COMPLETED (T2 GTN CASE), WHILE THE SCRUB TECH WAS DISASSEMBLING THE INSTRUMENT (GTN TARGETER), THE STRIKE PLATE FELL OFF AND LEFT THE THREADS THREADED INTO THE TARGETER. THERE WAS NO ADVERSE CONSEQUENCE TO THE PT AND SURGERY WAS COMPLETED SUCCESSFULLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TARGET DEVICE T2 GTN INSTRUMENT LXH STRYKER OSTEOSYNTHESIS KIEL NA KME903991

Patients

Seq Age Sex Outcome Treatment
1 UNK Other