inforMED
MalfunctionCCX

DR. DON'S ARM SUSPENSION KIT; (051724); STERILE

Received Sep 21, 2020 · Event occurred May 1, 2020

Report 1836161-2020-00044 · MDR key 10559486

Device

Generic name

Patient Positioning - Shoulder

Model number

711503

Lot number

021418

Product problems

  • Break

Patient

Not reported

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

NO FURTHER INFORMATION IS AVAILABLE ON THE PRODUCT AT THIS TIME. THE INVESTIGATION IS ONGOING, HOWEVER IF ANY ADDITIONAL RELEVANT INFORMATION IS IDENTIFIED FOLLOWING COMPLETION OF THE INVESTIGATION, THE ADDITIONAL RELEVANT INFORMATION WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT. DEVICE NOT AVAILABLE.

Description of Event or Problem

ASPEN SURGICAL RECEIVED A MEDWATCH REPORT (UF/IMPORTER REPORT # (B)(4)) INDICATING THAT DURING A SHOULDER SURGERY, THE STRAP CONNECTING THE RING TO THE SUSPENSION DEVICE BROKE, CAUSING THE ARM TO FALL DURING THE SURGICAL PROCEDURE. NO PATIENT HARM WAS REPORTED. THIS INCIDENT WAS FILED IN OUR COMPLAINT HANDLING SYSTEM UNDER NUMBER (B)(4).