MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2019-03-26 for CRANIOFIX 2 TITANIUM CLAMP 16MM FF491T manufactured by Aesculap Ag.
[139898314]
(b)(4). If new information becomes available a follow up report will be submitted.
Patient Sequence No: 1, Text Type: N, H10
[139898315]
It was reported the upper disk disengaged intraoperatively. It was reported that during a neurosurgical procedure the upper disk of the craniofix clamp disengaged from the pin after the pin was cut using a craniofix pin cutter. The upper disk was unable to hold onto the pin after the pin was cut. The surgery was completed with a replacement clamp. No other information has been provided. Additional information has been requested, however, not yet received.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9610612-2019-00194 |
| MDR Report Key | 8453450 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2019-03-26 |
| Date of Report | 2019-03-26 |
| Date of Event | 2019-02-19 |
| Date Facility Aware | 2019-03-14 |
| Date Mfgr Received | 2019-02-26 |
| Device Manufacturer Date | 2017-07-26 |
| Date Added to Maude | 2019-03-26 |
| 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 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. NICOLE BROYLES |
| Manufacturer Street | 615 LAMBERT POINTE DRIVE |
| Manufacturer City | HAZELWOOD MO 63042 |
| Manufacturer Country | US |
| Manufacturer Postal | 63042 |
| Manufacturer Phone | 3145515988 |
| Manufacturer G1 | AESCULAP AG |
| Manufacturer Street | PO BOX 40 |
| Manufacturer City | TUTTLINGEN, 78501 |
| Manufacturer Country | GM |
| Manufacturer Postal Code | 78501 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | CRANIOFIX 2 TITANIUM CLAMP 16MM |
| Generic Name | CRANIOFIX 2 IMPLANTS |
| Product Code | GXR |
| Date Received | 2019-03-26 |
| Returned To Mfg | 2019-03-12 |
| Model Number | FF491T |
| Catalog Number | FF491T |
| Lot Number | 52351897 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | 18 MO |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | AESCULAP AG |
| Manufacturer Address | PO BOX 40 TUTTLINGEN, 78501 GM 78501 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-03-26 |