MAUDE Adverse Event Report: MAKO SURGICAL CORP. BONE PIN, 3.2MM X 80MM, STERILE 2 PACK; STEREOTAXIC DEVICE, ROBOTICS

Catalog Number	143080
Medical Device Problem Codes	Break (1069); Non Reproducible Results (4029)
Health Effect - Clinical Code	No Known Impact Or Consequence To Patient (2692)
Date of Event	09/24/2018
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
As part of normal complaint follow-up, an evaluation of the event has been initiated by mako surgical.A supplemental report will be submitted when additional information becomes available.
Event or Problem Description
3.2mm mako pin tip broke off in patient tibia whilst removing pin at end of mako tka case.
Additional Manufacturer Narrative
Reported event: it was reported that 3.2mm mako pin tip broke off in patient tibia whilst removing pin at end of marko.Product evaluation and results: the product was unavailable for inspection as the product was not returned.Product history review: review of the product history records indicate (b)(4) devices were manufactured under lot no w50959-1 and accepted into final stock on 07/10/2017.No non-conformances were identified during inspection.Complaint history review: a review of complaints in catsweb and trackwise related to p/n 143080, lot number w50959-1 shows no additional complaints related to the failure in this investigation.Conclusions: the failure mode could not be confirmed because the part was not available for evaluation.If device and/or additional information become available, this investigation will be reopened.Corrective action/preventive action: a review of stryker¿s nc/capa database indicated there have been 01 ncs (b)(4) and capas 1480798 are associated with the product and failure mode reported in this event.Device not returned.
Event or Problem Description
3.2mm mako pin tip broke off in patient tibia whilst removing pin at end of mako tka case.

• Brand Name: BONE PIN, 3.2MM X 80MM, STERILE 2 PACK
• Common Device Name: STEREOTAXIC DEVICE, ROBOTICS
• Manufacturer (Section D): MAKO SURGICAL CORP.; 2555 davie road; fort lauderdale FL 33317
• MDR Report Key: 7970485
• Report Number: 3005985723-2018-00602
• Device Sequence Number: 16447665
• Product Code: OLO
• UDI-Device Identifier: 00848486018122
• UDI-Public: 00848486018122
• Combination Product (Y/N): N
• Initial Reporter Country: AU
• PMA/510(K) Number: K112507
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2018
• Reporter Type: Manufacturer
• Report Source: health professional
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date (Section B): 01/02/2019

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?: Yes
• Operator of Device: Health Professional
• Device Catalogue Number: 143080
• Device Lot Number: W50959-1
• Was Device Available for Evaluation?: No
• Initial Date Received by Manufacturer: 10/04/2018
• Supplement Date Received by Manufacturer: 12/26/2018
• Initial Report FDA Received Date: 10/16/2018
• Supplement Report FDA Received Date: 01/02/2019
• 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: Hospitalization
• Patient Age: 66 YR
• Patient Weight: 76