FDA Adverse Event Malfunction Summary report: N

ORTHOLOC(R) STAR DRIVER 7

MDR report key: 6096862 · Received November 11, 2016

Report

Report Number
1043534-2016-00119
Event Type
Malfunction
Date Received
November 11, 2016
Date of Event
November 4, 2016
Report Date
November 11, 2016
Manufacturer
WRIGHT MEDICAL TECHNOLOGY, INC.
Product Code
HWR
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION IS NOT COMPLETE. A FOLLOW UP REPORT WILL BE SUBMITTED UPON COMPLETION OF INVESTIGATION.

Description of Event or Problem · 1

ALLEGEDLY, THE DRIVER BROKE DURING SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
748150 ORTHOLOC(R) STAR DRIVER 7 SMALL JOINT INSTRUMENT HWR WRIGHT MEDICAL TECHNOLOGY, INC. 5202000016 1582087

Patients

Seq Age Sex Outcome Treatment
1