BEUDAMED
    FDA Adverse Event Other Summary report: N

    CE T-25 SCREW DRIVER

    MDR report key: 836704 · Received April 4, 2007

    Report

    Report Number
    MW1042510
    Event Type
    Other
    Date Received
    April 4, 2007
    Date of Event
    April 2, 2007
    Report Date
    April 4, 2007
    Manufacturer
    MEDTRONIC
    Product Code
    HXX
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    SCREW DRIVER BROKE OFF WHILE PLACING A SCREW INTO THE SPINE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CE T-25 SCREW DRIVER SCREW DRIVER HXX MEDTRONIC CE T-25 815-518 BM 3L002

    Patients

    Seq Age Sex Outcome Treatment
    1 47 YR Other