FDA Adverse Event Malfunction Summary report: N

SCREWDRIVER HANDLE REVOLVING TYPE

MDR report key: 3250782 · Received July 29, 2013

Report

Report Number
0008010177-2013-00174
Event Type
Malfunction
Date Received
July 29, 2013
Date of Event
June 12, 2013
Report Date
July 4, 2013
Manufacturer
STRYKER OSTEOSYNTHESIS-FREIBURG
Product Code
LXH
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE REPORTED EVENT COULD NOT BE CONFIRMED BECAUSE THE DEVICE WAS NOT RETURNED FOR EVALUATION HENCE IT IS NOT POSSIBLE TO PERFORM THE PRODUCT SPECIFIC EXAMINATIONS AND THE ROOT CAUSE FOR THE REPORTED EVENT CANNOT BE DETERMINED. HOWEVER, ACCORDING TO THE PROVIDED EMAIL IT WAS STATED PER SERVICE TECHNICIAN THAT THE DAMAGE OF THE PRODUCT WAS CAUSED DUE TO THE USE/MISUSE AT THE CUSTOMER SITE. DEVICE NOT RETURNED.

Additional Manufacturer Narrative · 1

INVESTIGATION IN PROGRESS BUT NOT YET COMPLETE.

Description of Event or Problem · 1

AS PER THE REPORTER SCREWDRIVER HANDLE WAS BROKEN DURING OPERATION.

Description of Event or Problem · 1

AS PER THE REPORTER SCREWDRIVER HANDLE WAS BROKEN DURING OPERATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
353327 SCREWDRIVER HANDLE REVOLVING TYPE INSTRUMENT LXH STRYKER OSTEOSYNTHESIS-FREIBURG 1000061669

Patients

Seq Age Sex Outcome Treatment
1