FDA Adverse Event
Malfunction
Summary report: N
2.5MM DRILL BIT/QC/GOLD/110MM
MDR report key: 4308869
·
Received December 9, 2014
Report
- Report Number
- 2520274-2014-15224
- Event Type
- Malfunction
- Date Received
- December 9, 2014
- Report Date
- November 12, 2014
- Manufacturer
- SYNTHES (USA)
- Product Code
- HTW
- PMA / PMN Number
- PK962913
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- HEALTH PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. ADDITIONAL COMMON DEVICE NAME: HSZ. DEVICE IS AN INSTRUMENT AND IS NOT IMPLANTED/EXPLANTED. WITHOUT A LOT NUMBER, THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.
Description of Event or Problem · 1
THE SYNTHES COMPLAINT HANDLING UNIT RECEIVED A (B)(4) VIA STANDARD MAIL ON 11/12/2014. ONLY ADDITIONAL AND/OR CORRECTED INFORMATION WILL BE CONTAINED IN THIS REPORT. THIS IS REPORT 1 OF 1 FOR (B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 794825 | 2.5MM DRILL BIT/QC/GOLD/110MM | BIT,DRILL | HTW | SYNTHES (USA) |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |