NAVIO BONE SCREW DRIVER PFSR110164

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 NAVIO BONE SCREW DRIVER PFSR110164 manufactured by Blue Belt Technologies.

Event Text Entries

[188508135] It was reported that when starting the tka procedure, the navio pin driver became stripped and the pin was freely spinning in the pin driver. Another tray was opened and the equipment was swapped out to continue with the procedure with a delay of fewer than 30 minutes. There was no patient injury involved. No other complications were reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3010266064-2020-00106
MDR Report Key9906202
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-31
Date of Report2020-03-31
Date of Event2020-03-11
Date Mfgr Received2020-03-11
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
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. RICK CONFER
Manufacturer Street2828 LIBERTY AVE SUITE 100
Manufacturer CityPITTSBURGH PA 38116
Manufacturer CountryUS
Manufacturer Postal38116
Manufacturer Phone4126833844
Manufacturer G1BLUE BELT TECHNOLOGIES
Manufacturer Street2905 NORTHWEST BLVD STE 40 SUITE 100
Manufacturer CityPLYMOUTH MN 55441
Manufacturer CountryUS
Manufacturer Postal Code55441
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameNAVIO BONE SCREW DRIVER
Generic NameORTHOPEDIC STEREOTAXIC INSTRUMENT
Product CodeOLO
Date Received2020-03-31
Model NumberPFSR110164
Catalog NumberPFSR110164
OperatorHEALTH PROFESSIONAL
Device Availability*
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBLUE BELT TECHNOLOGIES
Manufacturer Address2905 NORTHWEST BLVD STE 40 PLYMOUTH MN 55441 US 55441


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-31

© 2024 FDA.report
This site is not affiliated with or endorsed by the FDA.