FDA Adverse Event Malfunction Summary report: N

ACCULIF PL INSERTION HANDLE

MDR report key: 5485512 · Received March 8, 2016

Report

Report Number
3004024955-2016-00022
Event Type
Malfunction
Date Received
March 8, 2016
Date of Event
February 10, 2016
Report Date
February 10, 2016
Manufacturer
STRYKER SPINE-US
Product Code
LXH
UDI-DI
07613327105926
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

METHOD: VISUAL INSPECTION; DEVICE HISTORY REVIEW; COMPLAINT HISTORY REVIEW; RISK ASSESSMENT. RESULTS: THE RETURNED DEVICE WAS CONFIRMED TO HAVE A FRACTURED WELD ON THE DISTAL TIP UPON VISUAL INSPECTION. NO RELEVANT MANUFACTURING ISSUES WERE IDENTIFIED AS ALL RELEASED UNITS MET STRYKER SPECIFICATIONS. CONCLUSION: THE PLAUSIBLE ROOT CAUSE OF THE REPORTED EVENT CANNOT BE IDENTIFIED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE TIP OF AN INSERTER SEPARATED FROM THE INSTRUMENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE TIP OF AN INSERTER SEPARATED FROM THE INSTRUMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
143183 ACCULIF PL INSERTION HANDLE ORTHOPEDIC MANUAL SURGICAL INSTRUMENT LXH STRYKER SPINE-US 05061401-6 07613327105926

Patients

Seq Age Sex Outcome Treatment
1