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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: IMPLANTCAST GMBH DRILL A/O CHUCK 2,0 MM

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IMPLANTCAST GMBH DRILL A/O CHUCK 2,0 MM Back to Search Results
Model Number 77000020
Device Problem Fracture (1260)
Patient Problem Foreign Body In Patient (2687)
Event Date 02/19/2021
Event Type  Injury  
Manufacturer Narrative
The suspected medical device drill a/o chuck 2,0 mm is not listed/approved in the us, but is similar to the following devices listed/approved in the us: drill 2,5 mm ao no product was available for the analysis.The drill used is very filigree at 2.0mm.During drilling, it is guided through the drill sleeve or the drilling template.For an unknown reason, the drill bit may have jammed, which then probably broke during further feed.Removal of the drill would have resulted in disproportionate damage to the bone.As a result, a part of the broken drill was left in the bone.No review of the product and manufacturing documentation could be performed because the lot of the product was unknown.The content of the surgical technique and the instructions for use have been checked, and no faults were found.The occurrence rate is below the accepted threshold.
 
Event Description
On (b)(6) 2020, a patient underwent revision surgery on the right shoulder.During preparation of the glenoid for implantation, the drill broke off.The broken off end of the drill got stuck so deep in the bone that it could not be removed.
 
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Brand Name
DRILL A/O CHUCK 2,0 MM
Type of Device
DRILL A/O CHUCK 2,0 MM
Manufacturer (Section D)
IMPLANTCAST GMBH
lueneburger schanze 26
buxtehude, lower saxony 21614
GM  21614
Manufacturer (Section G)
IMPLANTCAST GMBH
lueneburger schanze 26
buxtehude, lower saxony 21614
GM   21614
Manufacturer Contact
frank ansorge
lueneburger schanze 26
buxtehude, lower saxony 21614
GM   21614
MDR Report Key18334513
MDR Text Key330596068
Report Number3012523063-2023-00018
Device Sequence Number1
Product Code HTW
Combination Product (y/n)N
Reporter Country CodeUK
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Distributor
Reporter Occupation Physician
Type of Report Initial
Report Date 12/15/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Model Number77000020
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 02/26/2021
Initial Date FDA Received12/15/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
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