FDA Adverse Event Malfunction Summary report: N

CANNULATED HEX SCREWDRIVER 2.5MM

MDR report key: 787147 · Received November 22, 2006

Report

Report Number
2027970-2006-00005
Event Type
Malfunction
Date Received
November 22, 2006
Date of Event
October 20, 2006
Report Date
October 25, 2006
Manufacturer
ARTHROTEK, INC.
Product Code
HXX
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

REVIEW OF DEVICE HISTORY RECORDS SHOW THAT LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION. NO FURTHER COMPLICATIONS HAVE BEEN REPORTED. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT.

Description of Event or Problem · 1

HEX END OF SCREWDRIVER BROKE IN INTERFERENCE SCREW. ADDED 30 MINUTES TO CASE DUE TO HAVING TO RETRIEVE BROKEN PART. SCREWDRIVER WAS STUCK IN THE SCREW AND BROKE WHEN SURGEON PULLED DRIVER OUT OF WOUND SITE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CANNULATED HEX SCREWDRIVER 2.5MM HXX HXX ARTHROTEK, INC. * 039880

Patients

Seq Age Sex Outcome Treatment
1 * Required Intervention