MAUDE Adverse Event Report: STRYKER TRAUMA KIEL BONE PLUG EXTRACTOR T2 ICF; ORTHOPEDIC MANUAL SURGICAL INSTRUMENT

Model Number	2358-3200
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code	Bone Fracture(s) (1870)
Date of Event	08/26/2020
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
Device was not returned.If additional information becomes available, it will be provided in a supplemental report.
Event or Problem Description
Surgeon treated a chronic charcot foot in a medial column procedure and provided the following feedback: ¿crown drill and bone plug seemed intuitive but it was a little struggle.¿ additional info received: "the struggle with the crown drill / bone plug extractor was it was too big for the patient and fractured the proximal portion of the 1st met head.It did not alter the outcome of the case.".

• Brand Name: BONE PLUG EXTRACTOR T2 ICF
• Common Device Name: ORTHOPEDIC MANUAL SURGICAL INSTRUMENT
• Manufacturer (Section D): STRYKER TRAUMA KIEL; prof. kuentscher-strasse 1-5; schoenkirchen/kiel D-242 32; GM D-24232
• MDR Report Key: 10576706
• Report Number: 0009610622-2020-00538
• Device Sequence Number: 14329491
• Product Code: LXH
• UDI-Device Identifier: 07613327346466
• UDI-Public: 07613327346466
• Combination Product (Y/N): N
• Initial Reporter State: AZ
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: health professional
• Initial Reporter Occupation: Physician
• Type of Report: Initial
• Report Date (Section B): 09/23/2020

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
• Operator of Device: Health Professional
• Device Model Number: 2358-3200
• Device Catalogue Number: 23583200
• Device Lot Number: UNKNOWN
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 08/27/2020
• Initial Report FDA Received Date: 09/23/2020
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Other