MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06,08 report with the FDA on 2005-04-26 for INTERNAL SCREWDRIVER * 119840 manufactured by Newdeal S.a..
[397779]
When the surgeon turned the internal screwdriver to expand the implant, the tip of the screwdriver broke off inside the implant during a procedure. The implant was then removed. Another implant could not be used because the screwdriver was broken and there was no other screwdriver available. There was no additional info availble.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9615741-2005-00007 |
| MDR Report Key | 596348 |
| Report Source | 06,08 |
| Date Received | 2005-04-26 |
| Date of Report | 2005-04-26 |
| Date Mfgr Received | 2005-03-29 |
| Date Added to Maude | 2005-04-29 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 0 |
| Manufacturer Contact | YANPING WANG |
| Manufacturer Street | 311C ENTERPRICE DRIVE |
| Manufacturer City | PLAINSBORO NJ 08536 |
| Manufacturer Country | US |
| Manufacturer Postal | 08536 |
| Manufacturer Phone | 6099362322 |
| Manufacturer G1 | NEWDEAL S.A. |
| Manufacturer Street | 10, PLACE D'HELVETIE |
| Manufacturer City | LYON 69006 |
| Manufacturer Country | FR |
| Manufacturer Postal Code | 69006 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | INTERNAL SCREWDRIVER |
| Generic Name | KALIX IMPLANT ASSOCIATED INSTRUMENTS |
| Product Code | KXX |
| Date Received | 2005-04-26 |
| Model Number | * |
| Catalog Number | 119840 |
| Lot Number | BM |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | Y |
| Implant Flag | N |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 586159 |
| Manufacturer | NEWDEAL S.A. |
| Manufacturer Address | * LYON FR |
| Baseline Brand Name | INTERNAL SCREWDRIVER |
| Baseline Generic Name | KALIX IMPLANT ASSOCIATED INSTRUMENTS |
| Baseline Model No | * |
| Baseline Catalog No | 119840 |
| Baseline ID | * |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2005-04-26 |