FDA Adverse Event Malfunction Summary report: N

GUIDEWIRE

MDR report key: 9854 · Received August 29, 1994

Report

Report Number
9854
Event Type
Malfunction
Date Received
August 29, 1994
Date of Event
July 21, 1994
Report Date
July 29, 1994
Manufacturer
SYNTHES
Product Code
MKI
Product Problem
Yes
Report Source
User Facility report

Narratives

Description of Event or Problem · 1

PATIENT IN SURGERY FOR FIRST, SECOND AND THIRD METATARSOCUNEIFORM JOINT FUSION RIGHT FOOT. APPROXIMATELY 2 CM. PIECE OF SCREW SET GUIDEWIRE BROKE OFF IN BONE. SURGEONS CHOSE NOT TO REMOVE RETAINED GUIDEWIRE. FOLLOW UP PHONE CALL TO PATIENT INDICATED NO COMPLAINTS FROM PATIENT.INVALID DATA - REGARDING SINGLE USE LABELING OF DEVICE. PATIENT MEDICAL STATUS PRIOR TO EVENT: SATISFACTORY CONDITION. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY.NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. INVALID DATA - WHETHER DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: ACTUAL DEVICE INVOLVED IN INCIDENT WAS EVALUATED, VISUAL EXAMINATION. RESULTS OF EVALUATION: NONE OR UNKNOWN, GUIDEWIRE. CONCLUSION: DEVICE FAILURE DIRECTLY CONTRIBUTED TO EVENT. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: DEVICE PERMANENTLY REMOVED FROM SERVICE. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GUIDEWIRE MKI SYNTHES

Patients

Seq Age Sex Outcome Treatment
1 40 YR Other