MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC HANDLE 9734410 RATCHETING EGG; ORTHOPEDIC STEREOTAXIC INSTRUMENT

Model Number	9734410
Medical Device Problem Code	Material Integrity Problem (2978)
Health Effect - Clinical Code	No Patient Involvement (2645)
Date of Event	09/11/2018
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The ratcheting handle was returned to the manufacturer for analysis.Analysis found that the end cap had been broken off and was missing.Otherwise, the ratchet and tool retention mechanisms were intact and functional.The hardware investigation found that the reported event was related to a hardware issue.This issue was documented in a medtronic navigation hardware anomaly tracking database.If information is provided in the future, a supplemental report will be issued.
Event or Problem Description
Medtronic received information regarding a navigation device being used outside of a procedure.It was reported that the top of the ratcheting handle was missing.There was no patient present when this issue was observed.

• Brand Name: HANDLE 9734410 RATCHETING EGG
• Common Device Name: ORTHOPEDIC STEREOTAXIC INSTRUMENT
• Manufacturer (Section D): MEDTRONIC NAVIGATION, INC; 826 coal creek circle; louisville CO 80027
• MDR Report Key: 7954049
• Report Number: 1723170-2018-05067
• Device Sequence Number: 1381333
• Product Code: OLO
• UDI-Device Identifier: 00613994724007
• UDI-Public: 00613994724007
• Combination Product (Y/N): N
• Initial Reporter State: DE
• Initial Reporter Country: US
• PMA/510(K) Number: K124004
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: user facility
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial
• Report Date (Section B): 10/10/2018

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Operator of Device: Health Professional
• Device Model Number: 9734410
• Device Catalogue Number: 9734410
• Device Lot Number: 104233
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 10/04/2018
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 09/11/2018
• Initial Report FDA Received Date: 10/10/2018
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1