FDA Adverse Event Malfunction Summary report: N

STEALTHSTATION S7 SYSTEM

MDR report key: 2920345 · Received January 17, 2013

Report

Report Number
1723170-2013-00031
Event Type
Malfunction
Date Received
January 17, 2013
Date of Event
December 19, 2012
Report Date
December 19, 2012
Manufacturer
MEDTRONIC NAVIGATION, INC.
Product Code
HAW
PMA / PMN Number
K050438
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

NO PATIENT INFORMATION PROVIDED AS NO PATIENT WAS INVOLVED IN THIS CONCERN. MEDTRONIC REPRESENTATIVE AT THE SITE IDENTIFIED THE ISSUE WITH THE VERTEK ARM AND REQUESTED REPLACEMENT. THE SITE OPTED NOT TO REPLACE THEIR VERTEK ARM; NO RMA WAS ISSUED. SUSPECT DEVICE HAS NOT BEEN RETURNED TO MANUFACTURER FOR FURTHER EVALUATION.

Description of Event or Problem · 1

A MEDTRONIC REPRESENTATIVE REPORTED A VERTEK ARM THAT WOULD NOT TIGHTEN PROPERLY. THERE WAS NO PATIENT PRESENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
26468 STEALTHSTATION S7 SYSTEM NEUROLOGICAL STEREOTAXIC INSTRUMENT HAW MEDTRONIC NAVIGATION, INC. S7

Patients

Seq Age Sex Outcome Treatment
1