FDA Adverse Event Malfunction Summary report: N

STANDARD DRILL BIT ANCHORAGE 2.0MM / L110MM, AO

MDR report key: 2945754 · Received January 4, 2013

Report

Report Number
8031020-2013-90002
Event Type
Malfunction
Date Received
January 4, 2013
Date of Event
December 12, 2012
Report Date
December 12, 2012
Manufacturer
STRYKER OSTEOSYNTHESIS SELZACH
Product Code
HBE
PMA / PMN Number
NA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ONCE THE INVESTIGATION HAS BEEN COMPLETED ANY ADDITIONAL INFORMATION WILL BE REPORTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

SURGEON WAS DRILLING 3RD OR 4TH HOLE INTO METATARSAL PHALANGEAL REGION WHEN THE DRILL BIT BROKE OFF IN THE PATIENT'S BONE. X-RAY SHOWED IT WAS THERE AND ATTEMPTED TO GET IT OUT BUT WAS IMPOSSIBLE. SURGEON DECIDED TO LEAVE IT IN THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
5048 STANDARD DRILL BIT ANCHORAGE 2.0MM / L110MM, AO INSTRUMENT HBE STRYKER OSTEOSYNTHESIS SELZACH NA C100266-10-00

Patients

Seq Age Sex Outcome Treatment
1 52 YR Other