FDA Adverse Event Other Summary report: N

SUMMIT SYSTEM

MDR report key: 294196 · Received September 1, 2000

Report

Report Number
1526439-2000-00014
Event Type
Other
Date Received
September 1, 2000
Date of Event
August 3, 2000
Report Date
August 31, 2000
Manufacturer
DEPUY ACROMED, INC.
Product Code
HWC
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

DEPUY ACROMED WAS INFORMED BY A SALES REP THAT 3 SUMMIT BONE SCREWS BROKE DURING INSERTION INTO THE SPINE. THE BROKEN PIECES OF THE SCREWS WERE LEFT IN THE BONE. IT WAS NOTED BY THE COMPLAINANT THAT THE BONE WAS EXTREMELY DENSE SO OVER-TORQUING OR EXCESSIVE FORCE COULD BE THE CAUSE OF THE BREAKAGE. THE BROKEN SCREWS WERE NOT RETURNED FOR EVALUATION. NO FURTHER EVALUATION CAN BE PERFORMED AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SUMMIT SYSTEM BONE SCREW HWC DEPUY ACROMED, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 44 YR Other