FDA Adverse Event Malfunction Summary report: N

TARGET DEVICE GAMMA3 300X160MM

MDR report key: 2934105 · Received December 19, 2012

Report

Report Number
9610622-2012-00603
Event Type
Malfunction
Date Received
December 19, 2012
Date of Event
December 11, 2012
Report Date
December 12, 2012
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
LXH
PMA / PMN Number
NA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ONCE THE INVESTIGATION HAS BEEN COMPLETED ANY ADD'L INFO WILL BE REPORTED IN A SUPPLEMENTAL REPORT. ADD'L DEVICE: 1320-0150 GUIDE WIRE SLEEVE GAMMA3 10.5X268MM UNK.

Description of Event or Problem · 1

DURING G3 SURGERY, THE SURGEON INSERTED GUIDE WIRE FOR LAG SCREW, AFTER INSERTING THE NAIL. HOWEVER, THE GUIDE WIRE WAS INSERTED IN THE UPPER PART OF THE NAIL. THE SURGEON REMOVED THE NAIL AND CHECKED, THE LAG SCREW ANGLE OF THE NAIL AND THE TARGET ARM WAS NOT IN CONFORMANCE. THE OPERATION CONTINUED. AFTERWARDS, WHEN THE STEP DRILL WAS USED, THE DRILL WAS STUCK IN THE LAG SCREW HOLE OF NAIL. THE SURGEON LOOSENED THE NAIL HOLDING SCREW AND REMOVED THE STEP DRILL. THE SURGERY WAS COMPLETED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TARGET DEVICE GAMMA3 300X160MM INSTRUMENT LXH STRYKER OSTEOSYNTHESIS KIEL NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Other