inforMED
MalfunctionHTO

UNIVERSAL DRIVER SHAFT

Received Aug 21, 2003 · Event occurred Jul 21, 2003

Report 2243265-2003-00066 · MDR key 480219

Device

Generic name

Instrument

Model number

NA

Catalog number

2107-1015

Lot number

FXH211

Product problems

  • Device remains implanted
  • Tip breakage

Patient

62 YR

  • Unknown (for use when the patient's condition is not known)

Narrative

Description of Event or Problem

DURING IMPLANTING OF A TRIDENT AD SHELL, THE TIP OF THE INSTRUMENT BROKE OFF AND REMAINS IN THE HEAD OF THE SCREW.

Remedial action

  • Other