FDA Adverse Event Injury Summary report: N

.045" GUIDE WIRE TROCAR, THREADED

MDR report key: 9756771 · Received February 26, 2020

Report

Report Number
1220246-2020-01733
Event Type
Injury
Date Received
February 26, 2020
Date of Event
February 12, 2020
Report Date
February 26, 2020
Manufacturer
ARTHREX, INC.
Product Code
NBH
UDI-DI
00888867127203
PMA / PMN Number
EXEMPT
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 1

THE CONTRIBUTION OF THE DEVICE TO THE REPORTED EVENT COULD NOT BE DETERMINED AS THE DEVICE WAS NOT RETURNED FOR EVALUATION. THE ROOT CAUSE OF THE EVENT COULD NOT BE DETERMINED FROM THE INFORMATION AVAILABLE AND WITHOUT DEVICE EVALUATION.

Description of Event or Problem · 1

IT WAS REPORTED DURING A LAPIDUS FUSION AND A MEDIALIZING CALCANEAL OSTEOTOMY PROCEDURE THE TIPS OF THE AR-8737-42 GUIDE WIRE TROCAR TIP WITH LASER LINE, AND AR-8750KT GUIDE WIRE WITH TROCAR TIP BROKE OFF WHERE THE THREADS START. THE REP REPORTED THE BROKEN TIPS WERE SO SMALL THAT THEY COULD NOT BE RETRIEVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
217716 .045" GUIDE WIRE TROCAR, THREADED ACCESSORIES, ARTHROSCOPIC NBH ARTHREX, INC. .045" GUIDE WIRE TROCAR, THREADED UNK 00888867127203

Patients

Seq Age Sex Outcome Treatment
1 Other