BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MOD HALF PIN 3X60 10 CONT THR

    MDR report key: 418024 · Received September 18, 2002

    Report

    Report Number
    8030968-2002-00003
    Event Type
    Malfunction
    Date Received
    September 18, 2002
    Date of Event
    July 12, 2002
    Report Date
    July 23, 2002
    Manufacturer
    STRYKER TRAUMA SA
    Product Code
    HTY
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    AFTER STICKING THE PIN INTO THE BONE, THE CUSTOMER WANTED TO PULL THE PIN BACK A LITTLE. WHEN THE CUSTOMER WAS PULLING THE PIN BACK, THE PIN BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MOD HALF PIN 3X60 10 CONT THR IMPLANT HTY STRYKER TRAUMA SA NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other