FDA Adverse Event Malfunction Summary report: N

UNIVERSAL RECIPROCATING SAW ATTACHMENT

MDR report key: 3113117 · Received May 9, 2013

Report

Report Number
8031000-2013-00027
Event Type
Malfunction
Date Received
May 9, 2013
Date of Event
April 15, 2013
Report Date
April 15, 2013
Manufacturer
ZIMMER SURGICAL S.A.
Product Code
HAB
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RETURNED TO THE MANUFACTURER; HOWEVER THE INVESTIGATION WAS NOT COMPLETED AT THE TIME OF THIS REPORT. A FOLLOW UP MEDWATCH WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A REVISION TOTAL KNEE REPLACEMENT, THE UNIVERSAL RECIPROCATING SAW ATTACHMENT EASILY RELEASED THE BLADE, LEAVING IT IN THE SURGICAL SITE AFTER APPROXIMATELY 6.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
204968 UNIVERSAL RECIPROCATING SAW ATTACHMENT NONE HAB ZIMMER SURGICAL S.A.

Patients

Seq Age Sex Outcome Treatment
1 SYNVASIVE DOUBLE SIDED RECIPROCATING BLADE:| (B)(4)