11G IVAS ACCESS CANNULA 0306330000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2016-10-21 for 11G IVAS ACCESS CANNULA 0306330000 manufactured by Stryker Instruments-kalamazoo.

Event Text Entries

[58063490] It was reported that during a surgical procedure at the user facility that the outer metal sheath of the cannula remained in the patient's pedicle as the physician tried to remove the device. The procedure was completed successfully and no injuries or additional adverse consequences were reported; however, the device material left behind took 45 minutes to remove.
Patient Sequence No: 1, Text Type: D, B5


[75742029]
Patient Sequence No: 1, Text Type: N, H10


[75742030] It was reported that during a surgical procedure at the user facility that the outer metal sheath of the cannula remained in the patient's pedicle as the physician tried to remove the device. The procedure was completed successfully and no injuries or additional adverse consequences were reported; however, the device material left behind took 45 minutes to remove.
Patient Sequence No: 1, Text Type: D, B5


[93609188]
Patient Sequence No: 1, Text Type: N, H10


[93609189] It was reported that during a surgical procedure at the user facility that the outer metal sheath of the cannula remained in the patient's pedicle as the physician tried to remove the device. The procedure was completed successfully and no injuries or additional adverse consequences were reported; however, the device material left behind took 45 minutes to remove.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001811755-2016-02607
MDR Report Key6047259
Report SourceUSER FACILITY
Date Received2016-10-21
Date of Report2017-09-18
Date of Event2016-10-10
Date Mfgr Received2017-03-16
Device Manufacturer Date2016-05-14
Date Added to Maude2016-10-21
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. CASEY METZGER
Manufacturer Street4100 EAST MILHAM AVENUE
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal49001
Manufacturer Phone2693237700
Manufacturer G1STRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Street4100 EAST MILHAM AVENUE HIGHWAY #3, KM 130.2
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal Code49001
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name11G IVAS ACCESS CANNULA
Generic NameINJECTOR, VERTEBROPLASTY (DOES NOT CONTAIN CEMENT)
Product CodeOAR
Date Received2016-10-21
Returned To Mfg2016-11-14
Catalog Number0306330000
Lot Number16135012
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Address4100 EAST MILHAM AVENUE KALAMAZOO MI 49001 US 49001


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2016-10-21

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