FDA Adverse Event Other Summary report: N

POLYAXIAL SCREWDRIVER LOCKING

MDR report key: 2854064 · Received September 14, 2012

Report

Report Number
3005739886-2012-00009
Event Type
Other
Date Received
September 14, 2012
Date of Event
August 22, 2012
Report Date
August 22, 2012
Manufacturer
TECH INDUSTRIES
Product Code
HXX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
DR
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

RESULTS, CONCLUSIONS: EVALUATION IN PROCESS, UPON COMPLETION A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PROCEDURE, WHEN REMOVING DRIVER FROM THE SCREW, THE TIP FRACTURED. THE FRACTURED TIP WAS RETAINED IN THE HEAD OF THE SCREW WHICH REMAINS IMPLANTED IN THE PATIENT. THE RETAINED TIP DID NOT INTERFERE WITH THE PLACING OF THE ROD OR THE LOCKING CAP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 POLYAXIAL SCREWDRIVER LOCKING POLYAXIAL SCREWDRIVR LOCKING HXX TECH INDUSTRIES 2315TI

Patients

Seq Age Sex Outcome Treatment
1 Other