FDA Adverse Event Malfunction Summary report: N

3.5MM LONG HEXAGONAL SCREWDRIVER WITH T-HANDLE

MDR report key: 2954432 · Received February 11, 2013

Report

Report Number
2520274-2013-00826
Event Type
Malfunction
Date Received
February 11, 2013
Report Date
March 5, 2009
Manufacturer
SYNTHES
Product Code
KWP
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT. DEVICE IS EXEMPT. THIS INDIVIDUAL ADVERSE EVENT REPORT IS BEING MADE IN ACCORDANCE WITH THE SYNTHES MDR EXEMPTION REQUEST DATED OCTOBER 2011. A REVIEW OF THE EVENTS ASSOCIATED WITH THE REQUEST WAS PERFORMED AND IT WAS DETERMINED THAT NONE OF THE EVENTS CONSTITUTES SYSTEMIC ISSUES RELATED TO PRODUCT QUALITY, CHANGES IN PRODUCT DESIGN, METHOD OF USE, OR CHANGES IN EXPECTED RISK THRESHOLDS. REVIEW OF THE DATA ALSO INDICATED NO SIGNIFICANT CHANGE IN RISK/BENEFIT OF EACH PRODUCT CATEGORY, NO EVIDENCE OF DEFICIENCIES IN THE DESIGN, LABELING, OR MANUFACTURE OF THE DEVICE. AS NO LOT NUMBER WAS PROVIDED, NO DEVICE HISTORY RECORD REVIEW CAN BE PERFORMED. THE DEVICE IS NOT BEING RETURNED FOR EVALUATION, NO FURTHER INFORMATION IS AVAILABLE ON THIS EVENT. NO FURTHER INVESTIGATION CAN BE PERFORMED.

Description of Event or Problem · 1

(B)(4) COMPLAINT HANDLING UNIT REPORTED A PIN BROKE. THERE WERE CONCERNS OF POSSIBLE RISK, SINCE THE BROKEN PART REMAINED IN THE PATIENT. NO FURTHER INFORMATION WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
58183 3.5MM LONG HEXAGONAL SCREWDRIVER WITH T-HANDLE 3.5MM LONG HEXAGONAL KWP SYNTHES

Patients

Seq Age Sex Outcome Treatment
1