FDA Adverse Event Malfunction Summary report: N

STEALTHSTATION S7 SYSTEM

MDR report key: 2902312 · Received January 8, 2013

Report

Report Number
1723170-2013-00006
Event Type
Malfunction
Date Received
January 8, 2013
Date of Event
December 11, 2012
Report Date
December 11, 2012
Manufacturer
MEDTRONIC NAVIGATION, INC.
Product Code
HAW
PMA / PMN Number
K050438
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NO PATIENT INFORMATION PROVIDED AS NO PATIENT WAS INVOLVED IN THIS CONCERN. RMA ISSUED. REPLACEMENT VERTEK ARM SHIPPED TO SITE (B)(4) 2012. MEDTRONIC EVALUATION OF RETURNED SUSPECT DEVICE FINDS THE STARBURST END OF THE VERTEK ARM WILL NOT LOCK DOWN. MECHANICAL ISSUE DIRECTLY CAUSED EVENT.

Description of Event or Problem · 1

A SITE PURCHASING REPRESENTATIVE REPORTED THAT THEIR VERTEK ARM WILL NOT LOCK PROPERLY AND REQUESTED A REPLACEMENT. THIS ISSUE WAS DISCOVERED OUTSIDE OF SURGERY AND THIS VERTEK ARM IS NO LONGER IN USE AT THE SITE. THERE WAS NO PATIENT PRESENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
9503 STEALTHSTATION S7 SYSTEM NEUROLOGICAL STEREOTAXIC INSTRUMENT HAW MEDTRONIC NAVIGATION, INC. S7

Patients

Seq Age Sex Outcome Treatment
1