inforMED
MalfunctionHWI

CORKSCREW INSTRUMENT

Received Mar 3, 2022 · Event occurred Feb 10, 2022

Report MW5107889 · MDR key 13666933

Device

Generic name

Corkscrew

Manufacturer

Unk

Model number

71-5210 100221

Lot number

71-5210 100221

Product problems

  • Break

Patient

39 YR · Female

  • Foreign Body In Patient
  • Foreign Body In Patient

Narrative

Description of Event or Problem

(B)(6) 71-5210 100221 CORKSCREW INSTRUMENT AND IT BROKE INTO 2 PIECES INSIDE PATIENT'S PELVIS. BOTH PIECES WERE RETRIEVED WITH NO COMPLICATIONS OR HARM TO PATIENT. (B)(6). FDA SAFETY REPORT ID# (B)(4).