inforMED
MalfunctionHSH

ITOTAL TIBIAL IMPACTOR TIP

Received Oct 11, 2012 · Event occurred Sep 1, 2012

Report 3004153240-2012-00085 · MDR key 2831407

Device

Generic name

Reusable Impactor Tip

Manufacturer

Conformis, Inc.

Catalog number

ED-02611

Lot number

G1219

Product problems

  • Break

Patient

75 YR

  • No Consequences Or Impact To Patient

Narrative

Description of Event or Problem

TIBIAL TRAY IMPACTOR TIP BROKE AT THE POINT WHERE THE TRAY CONNECTS TO THE IMPACTOR HANDLE.

Additional Manufacturer Narrative

TIBIAL TRAY IMPACTOR TIP BROKE AT THE POINT WHERE THE TRAY CONNECTS TO THE IMPACTOR HANDLE. THE SURGERY WAS COMPLETED SUCCESSFULLY. REVIEW OF THE DEVICE HISTORY RECORD INDICATES THAT THE DEVICE WAS MANUFACTURED TO SPECIFICATION.