inforMED
MalfunctionKGS

PRELOADED MINI-REVO ANCHR

Received Dec 4, 1998 · Event occurred Sep 28, 1998

Report 1017294-1998-00047 · MDR key 200896

Device

Generic name

Revo

Model number

M74-139-400

Catalog number

C6109A

Lot number

00007107

Product problems

  • Bent
  • Break
  • Replace
  • Tip breakage

Patient

19 YR

  • No Consequences Or Impact To Patient
  • Unknown (for use when the patient's condition is not known)

Narrative

Description of Event or Problem

PT SCHEDULED FOR RIGHT SHOULDER ARTHROSCOPY AND REPAIR. THE MINI-REVO USED IN THIS PROCEDURE BROKE OFF AT THE EYELET PORTION. A SECOND MINI-REVO BROKE AND THIRD BENT DURING THIS PROCEDURE.