MAUDE Adverse Event Report: PAJUNK GMBH MEDIZINTECHNOLOGIE SPROTTE; SPINAL ANAESTHESIA CONDUCTION NEEDLE

Model Number 021151-29A

Device Problems Bent (1059); Fracture (1260); Human Factors Issue (2948); Device Handling Problem (3265)

Patient Problems Awareness during Anaesthesia (1707); Device Embedded In Tissue or Plaque (3165)

Event Date 04/26/2016

Event Type  Injury  

Manufacturer Narrative

Event took place in (b)(6) and has been reported through (b)(4).Currently, the data is poor and the device has not been sent back/ analysed.As soon as further data will be available, a follow up report will be sent in to the agency.

Event Description

(b)(4).Summarizing translation of user's narrative: upon puncture sprotte needle hit bone, navigated heavy, removed with stylet, needle tip got lost, surgical intervention to retrieve fragment.

Manufacturer Narrative

Event took place in (b)(6) and has been reported through (b)(4).Based on risk assessment and clinical evaluation, file is considered as closed.

Event Description

Internal report number: (b)(4).Summarizing translation of user's narrative: upon puncture sprotte needle hit bone, navigated heavy, removed with stylet, needle tip got lost, surgical intervention to retrieve fragment.

• Brand Name: SPROTTE
• Type of Device: SPINAL ANAESTHESIA CONDUCTION NEEDLE
• Manufacturer (Section D): PAJUNK GMBH MEDIZINTECHNOLOGIE; karl-hall-str. 1; geisingen, baden-wuerttemberg 78187 ; GM 78187
• Manufacturer (Section G): PAJUNK GMBH MEDIZINTECHNOLOGIE; karl-hall-str. 1; geisingen, baden-wuerttemberg 78187 ; GM 78187
• Manufacturer Contact: christian quass ; karl-hall-str. 1; regulatory & safety affairs; geisingen, baden-wuerttemberg 78187 ; GM 78187 ; 7704929158
• MDR Report Key: 5688084
• MDR Text Key: 46167819
• Report Number: 9611612-2016-00068
• Device Sequence Number: 1
• Product Code: BSP
• Combination Product (y/n): N
• Reporter Country Code: GM
• PMA/PMN Number: K911202
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,distri
• Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date: 07/08/2016

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 05/31/2016
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Physician
• Device Expiration Date: 01/01/2021
• Device Model Number: 021151-29A
• Device Catalogue Number: 021151-29A
• Device Lot Number: 1146
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 05/17/2016
• Is the Reporter a Health Professional?: No
• Date Manufacturer Received: 05/03/2016
• Was Device Evaluated by Manufacturer?: Yes
• Date Device Manufactured: 02/01/2016
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Other; Required Intervention
• Patient Age: 25 YR
• Patient Weight: 80