FDA Adverse Event Malfunction Summary report: N

SPEED SCREW 5.5 IMPLANT PROCEDURE SET

MDR report key: 3130178 · Received May 22, 2013

Report

Report Number
3006524618-2013-00204
Event Type
Malfunction
Date Received
May 22, 2013
Date of Event
April 29, 2013
Report Date
April 29, 2013
Manufacturer
ARTHROCARE CORPORATION
Product Code
MBI
PMA / PMN Number
K081893
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A ROTATOR CUFF REPAIR PROCEDURE USING THE SPEEDSCREW 5.5 IMPLANT PROCEDURE SET, THE SUTURES PULLED THROUGH THE CUFF UPON TIGHTENING THE SUTURE REELS. THE FACILITY OPTED TO COMPLETE THE PROCEDURE USING A COMPETITOR'S DEVICE. THERE WAS NO SIGNIFICANT DELAY OR PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
227251 SPEED SCREW 5.5 IMPLANT PROCEDURE SET FIXATION ANCHOR, LIGAMENT, NON BIODEGRADABLE MBI ARTHROCARE CORPORATION 1032428

Patients

Seq Age Sex Outcome Treatment
1 44 YR Other