FDA Adverse Event Malfunction Summary report: N

SPEEDLOCK PLUS PROCEDURE SET (W/BLUE COBRAID

MDR report key: 3050389 · Received April 8, 2013

Report

Report Number
3006524618-2013-00139
Event Type
Malfunction
Date Received
April 8, 2013
Date of Event
March 8, 2013
Report Date
March 8, 2013
Manufacturer
ARTHROCARE CORPORATION
Product Code
MBI
PMA / PMN Number
K090615
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A SHOULDER ARTHROSCOPY PROCEDURE USING THE SPEEDLOCK PLUS PROCEDURE SET, THE PEEK ANCHOR BROKE OFF WHILE INSIDE THE JOINT. THE ANCHOR WAS ABANDONED INSIDE THE BONE AND A NEW BONE HOLE WAS DRILLED, TO COMPLETE THE PROCEDURE USING A BACKUP ANCHOR. THERE WERE NO SIGNIFICANT DELAYS OR PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
142467 SPEEDLOCK PLUS PROCEDURE SET (W/BLUE COBRAID FIXATION ANCHOR, LIGAMENT, NON-BIODEGRAD MBI ARTHROCARE CORPORATION 1019709

Patients

Seq Age Sex Outcome Treatment
1 30 YR Other