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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER GMBH K-WIRE DRILL TIP AXSOS 3 TI Ø2.0 X 234MM; INSTRUMENT, SURGICAL, ORTHOPEDIC, AC-POWERED MOTOR AND ACCESSORY/ATTACHMENT

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STRYKER GMBH K-WIRE DRILL TIP AXSOS 3 TI Ø2.0 X 234MM; INSTRUMENT, SURGICAL, ORTHOPEDIC, AC-POWERED MOTOR AND ACCESSORY/ATTACHMENT Back to Search Results
Catalog Number 705002
Health Effect - Clinical Code No Known Impact Or Consequence To Patient (2692)
Date of Event 02/27/2019
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Device was not returned.If additional information becomes available, it will be provided in a supplemental report.Device disposition unknown.
 
Event or Problem Description
It was reported that, on (b)(6) 2019, dr.Was fixing a distal tibia fracture.During the implanting of two different screws, the screws snapped and broke in half.Additionally during drilling, the tip of the drill bit broke in the patient's body.The procedure was completed successfully, and no adverse consequences or surgical delay were reported.
 
Event or Problem Description
It was reported that, on (b)(6) 2019, dr.Was fixing a distal tibia fracture.During the implanting of two different screws, the screws snapped and broke in half.Additionally during drilling, the tip of the drill bit broke in the patient's body.The procedure was completed successfully, and no adverse consequences or surgical delay were reported.
 
Additional Manufacturer Narrative
The reported event could not be confirmed, since the device was not returned for evaluation and no other evidences were provided despite multiple attempts.More detailed information about the complaint event as well as the affected device must be available in order to determine the root cause of the complaint event.A review of the device history was not possible because the lot number was not communicated.No corrective actions are required at this time.A review of the labeling did not indicate any abnormalities.No indications of material, manufacturing or design related problems were found during the investigation.If the device is returned or if any additional information is provided, the investigation will be reassessed.
 
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Brand Name
K-WIRE DRILL TIP AXSOS 3 TI Ø2.0 X 234MM
Common Device Name
INSTRUMENT, SURGICAL, ORTHOPEDIC, AC-POWERED MOTOR AND ACCESSORY/ATTACHMENT
Manufacturer (Section D)
STRYKER GMBH
bohnackerweg 1
postfach
selzach 2545
CH  2545
MDR Report Key8464236
Report Number0008031020-2019-00336
Device Sequence Number1303382
Product Code HWE
UDI-Device Identifier07613327086157
UDI-Public07613327086157
Combination Product (Y/N)N
Initial Reporter StateNJ
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source health professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 05/10/2019
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 Catalogue Number705002
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Initial Date Received by Manufacturer 02/27/2019
Supplement Date Received by Manufacturer04/18/2019
Initial Report FDA Received Date03/29/2019
Supplement Report FDA Received Date05/10/2019
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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