KERRISON DET130 DEG UP 1MM 180MMTHP FK906R

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,07 report with the FDA on 2013-07-03 for KERRISON DET130 DEG UP 1MM 180MMTHP FK906R manufactured by Aesculap Ag & Co. Kg.

Event Text Entries

[3682992] Kerrison broke off at tip during acdf. Tip was found in pt. No pt injury or prolonging of surgery.
Patient Sequence No: 1, Text Type: D, B5


[10895357] Eval: the instrument was microscopically checked. The breakage area of the broken foot plate followed a pattern known as "transcrystalline force fracture". The direction of breakage is to the right front. Any hints for a material or mfg issue could not be found. Based on the investigation results, this issue is likely related to handling influences.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2916714-2013-00073
MDR Report Key3234477
Report Source01,07
Date Received2013-07-03
Date of Report2013-06-27
Date of Event2013-04-12
Date Mfgr Received2013-05-08
Device Manufacturer Date2009-01-01
Date Added to Maude2013-09-30
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMICHELLE LINK
Manufacturer Street615 LAMBERT POINTE DR.
Manufacturer CityHAZELWOOD MO 63042
Manufacturer CountryUS
Manufacturer Postal63042
Manufacturer Phone3145515938
Manufacturer G1AESCULAP AG & CO. KG
Manufacturer StreetP.O. BOX 40
Manufacturer CityTUTTLINGEN 78501
Manufacturer CountryGM
Manufacturer Postal Code78501
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameKERRISON DET130 DEG UP 1MM 180MMTHP
Product CodeGXJ
Date Received2013-07-03
Model NumberFK906R
Catalog NumberFK906R
ID NumberFK906R-B00BW
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerAESCULAP AG & CO. KG
Manufacturer AddressTUTTLINGEN DE 78532 DE 78532


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2013-07-03

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