FDA Adverse Event
Malfunction
Summary report: N
AIMING ARM A3 NAIL
MDR report key: 5328808
·
Received December 28, 2015
Report
- Report Number
- 0008031020-2015-00672
- Event Type
- Malfunction
- Date Received
- December 28, 2015
- Date of Event
- September 27, 2013
- Report Date
- October 1, 2013
- Manufacturer
- STRYKER GMBH
- Product Code
- HSB
- PMA / PMN Number
- K112982
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
WITH GUIDANCE FROM THE MDR POLICY BRANCH OF THE FDA, MDR REPORTED BY STRYKER GMBH, (B)(4) AS A RESULT OF A RETROSPECTIVE LOOKBACK OF COMPLAINTS RESULTING FROM THE ACQUISITION OF ASSETS FROM (B)(4). THE REPORTED DEVICE WAS MANUFACTURED AND DISTRIBUTED BY(B)(4), (B)(4), (B)(4) PURCHASED CERTAIN ASSETS OF (B)(4) ON AUGUST 1, 2014. STRYKER BECAME LEGAL MANUFACTURER OF THIS PRODUCT ON APRIL 1, 2015 AND HAS TAKEN THE RESPONSIBILITY FOR MEDICAL DEVICE REPORTING. DEVICE WILL NOT BE RETURNED. IF ADDITIONAL INFORMATION BECOMES AVAILABLE IT WILL BE PROVIDED ON A SUPPLEMENTAL REPORT.
Description of Event or Problem · 1
PIN ON THE AIMING ARM BROKE OFF DURING CASE. POSSIBLE CAUSE IS MIS-USE / TECHNIQUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 853597 | AIMING ARM A3 NAIL | ROD, FIXATION, INTRAMEDULLARY AND ACCESSORIES | HSB | STRYKER GMBH | 057159 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |