BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VUELOCK SCREW INSERTER

    MDR report key: 930655 · Received October 17, 2007

    Report

    Report Number
    2242816-2007-00050
    Event Type
    Malfunction
    Date Received
    October 17, 2007
    Date of Event
    October 1, 2007
    Report Date
    October 9, 2007
    Manufacturer
    EBI
    Product Code
    HXX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SF
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    LOT #'S MML003AG, M13038-01. MML003AG DATE OF MANUFACTURE, 03/2005. M13038-01 DATE OF MANUFACTURE, 08/2005.

    Description of Event or Problem · 1

    SCREW INSERTERS BROKE DURING NORMAL USE. PATIENT OUTCOME: FINE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VUELOCK SCREW INSERTER HXX EBI MMK167L

    Patients

    Seq Age Sex Outcome Treatment
    1 YR