ACCUTRAK - MINI * ATM080

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2001-06-11 for ACCUTRAK - MINI * ATM080 manufactured by Midwestern Medical Co..

Event Text Entries

[246126] Ankle arthroscopy procedure - used mini accutrak screw to fixate a fracture. When tightening the screw into place, the tip of screwdriver broke off. Broken piece removed from pt's ankle. Used a second screwdriver to finish tightening the screw into place and the same thing happened.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW1022147
MDR Report Key337333
Date Received2001-06-11
Date of Report2001-05-14
Date of Event2001-05-14
Date Added to Maude2001-06-18
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA0
Report to FDA0
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameACCUTRAK - MINI
Generic NameSCREW DRIVER
Product CodeHXY
Date Received2001-06-11
Model Number*
Catalog NumberATM080
Lot Number*
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key326637
ManufacturerMIDWESTERN MEDICAL CO.
Manufacturer Address1239 N HIGH ST COLUMBUS OH 43201 US


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2001-06-11

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