STARDRIVE SCRWDRVR SHFT/T4 50MM/SELF-RETAINING/HXC 03.130.010

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-03-31 for STARDRIVE SCRWDRVR SHFT/T4 50MM/SELF-RETAINING/HXC 03.130.010 manufactured by Wrights Lane Synthes Usa Products Llc.

Event Text Entries

[185907815] The device was received, the investigation is in progress, no conclusion could be drawn at the time of filing this report. Device was used for treatment, not diagnosis. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[185907816] It was reported that on march 01, 2020, a screwdriver stripped during a hand surgery. A second screwdriver was used to complete the procedure. There was no surgery delay. There was no patient consequence. This report involves one (1) stardrive scrwdrvr shft/t4 50mm/self-retaining/hxc. This is report 1 of 1 for (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2939274-2020-01617
MDR Report Key9903315
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-31
Date of Report2020-03-04
Date of Event2020-03-01
Date Mfgr Received2020-03-04
Date Added to Maude2020-03-31
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactKARA DITTY-BOVARD
Manufacturer Street1302 WRIGHTS LANE EAST
Manufacturer CityWEST CHESTER PA 19380
Manufacturer CountryUS
Manufacturer Postal19380
Manufacturer Phone6103142063
Manufacturer G1MONUMENT
Manufacturer Street1101 SYNTHES AVENUE
Manufacturer CityMONUMENT CO 80132
Manufacturer CountryUS
Manufacturer Postal Code80132
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSTARDRIVE SCRWDRVR SHFT/T4 50MM/SELF-RETAINING/HXC
Generic NameSCREWDRIVERS
Product CodeHXX
Date Received2020-03-31
Returned To Mfg2020-03-19
Model Number03.130.010
Catalog Number03.130.010
Lot NumberH544514
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerWRIGHTS LANE SYNTHES USA PRODUCTS LLC
Manufacturer Address1302 WRIGHTS LANE EAST WEST CHESTER PA 19380 US 19380


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-31

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