FDA Adverse Event Malfunction Summary report: N

QUICKSET ACE GRATER HEAD 48MM

MDR report key: 12289104 · Received August 6, 2021

Report

Report Number
1818910-2021-17353
Event Type
Malfunction
Date Received
August 6, 2021
Date of Event
January 1, 2021
Report Date
July 27, 2021
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
HTO
UDI-DI
10603295123958
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT # (B)(4). INVESTIGATION SUMMARY: THE DEVICE ASSOCIATED WITH THIS REPORT WAS NOT RETURNED. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY PRODUCT CONTRIBUTION TO THE REPORTED EVENT WITH THE INFORMATION PROVIDED. DEPUY SYNTHES CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION MAY BE RE-OPENED AS NECESSARY. DEVICE HISTORY LOT: A MANUFACTURING RECORD EVALUATION (MRE) WAS NOT POSSIBLE BECAUSE THE REQUIRED LOT CODE WAS NOT PROVIDED.

Additional Manufacturer Narrative · 1

(B)(4). IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THESE INSTRUMENTS ARE BLUNT DUE TO WEAR AND TEAR AND NEED REPLACING. THIS COMPLAINT CAPTURES IMPACTED PRODUCTS 121-136 OF MAIN COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1186157 QUICKSET ACE GRATER HEAD 48MM HIP INSTRUMENTS : REAMERS HTO DEPUY ORTHOPAEDICS INC US 2440-00-548 10603295123958

Patients

Seq Age Sex Outcome Treatment
1