FDA Adverse Event Malfunction Summary report: N

BENT HOHMANN RETRACTOR

MDR report key: 9258412 · Received October 30, 2019

Report

Report Number
3005985723-2019-00770
Event Type
Malfunction
Date Received
October 30, 2019
Date of Event
October 18, 2019
Report Date
December 30, 2019
Manufacturer
MAKO SURGICAL CORP.
Product Code
OLO
UDI-DI
00848486031909
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

REPORTED EVENT: BENT AND GOUGED. CASE TYPE: NO ASSOCIATED PROCEDURE. PRODUCT EVALUATION AND RESULTS: THE PRODUCT IS CONFIRMED TO BE A BENT HOHMANN RETRACTOR, P/N # 210191, LOT NUMBER 42224. PRODUCT HISTORY REVIEW: REVIEW OF THE PRODUCT HISTORY RECORDS INDICATE 99 DEVICES WERE MANUFACTURED UNDER LOT NO 42224 AND ACCEPTED INTO FINAL STOCK ON (B)(6) 2018. NO NON-CONFORMANCES WERE IDENTIFIED DURING INSPECTION. COMPLAINT HISTORY REVIEW: A REVIEW OF COMPLAINTS IN CATSWEB AND TRACKWISE RELATED TO P/N 210191, LOT NUMBER 42224, SHOWS 00 ADDITIONAL COMPLAINTS RELATED TO THE FAILURE IN THIS INVESTIGATION. CONCLUSIONS: THE EVENT IS CONFIRMED. PER (B)(4), PREVENTIVE MAINTENANCE IS WHERE AN ACTION OCCURS THAT IDENTIFIES DEVICE DETERIORATION WHICH MAY COMPROMISE FUNCTION. UNDER PM CONDITIONS NO PATIENT WAS INVOLVED AND NO ACTUAL OR POTENTIAL PATIENT HARM EXISTED FOR THE ALLEGED EVENT. NO ADDITIONAL INVESTIGATION OR SPECIFIC ACTIONS ARE REQUIRED. CORRECTIVE ACTION/PREVENTIVE ACTION: A REVIEW OF STRYKER¿S NC/CAPA DATABASE INDICATED THERE HAVE BEEN NO NC AND CAPA ASSOCIATED WITH THE PRODUCT AND FAILURE MODE REPORTED IN THIS EVENT.

Description of Event or Problem · 0

BENT AND GOUGED. CASE TYPE: NO ASSOCIATED PROCEDURE.

Additional Manufacturer Narrative · 1

AS PART OF THE NORMAL COMPLAINT FOLLOW-UP, AN EVALUATION OF THE EVENT HAS BEEN INITIATED BY MAKO SURGICAL. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE.

Description of Event or Problem · 1

BENT AND GOUGED. CASE TYPE: NO ASSOCIATED PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1051126 BENT HOHMANN RETRACTOR STEREOTAXIC DEVICE, ROBOTICS OLO MAKO SURGICAL CORP. 43244 00848486031909

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization