FDA Adverse Event Malfunction Summary report: N

VELYS SAW HANDPIECE

MDR report key: 13562380 · Received February 18, 2022

Report

Report Number
1818910-2022-03045
Event Type
Malfunction
Date Received
February 18, 2022
Date of Event
February 1, 2022
Report Date
February 17, 2022
Manufacturer
DEPUY IRELAND UC
Product Code
OLO
UDI-DI
10603295519430
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE. ADDITIONAL NARRATIVE: AS OF THIS DATE, THE DEVICE HAS NOT BEEN RETURNED FOR EVALUATION; THEREFORE, THE REPORTED CONDITION CANNOT BE CONFIRMED AND/OR DUPLICATED. CONCOMITANT MEDICAL DEVICES AND THERAPY DATES, SAW INTERFACE DEVICE RIGHT, FEBRUARY 1, 2022. UDI: (B)(4).

Additional Manufacturer Narrative · 0

IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE. ADDITIONAL NARRATIVE: AS OF THIS DATE, THE DEVICE HAS NOT BEEN RETURNED FOR EVALUATION; THEREFORE, THE REPORTED CONDITION CANNOT BE CONFIRMED AND/OR DUPLICATED. CONCOMITANT MEDICAL DEVICES AND THERAPY DATES, SAW INTERFACE DEVICE RIGHT, FEBRUARY 1, 2022. UDI: (B)(4).

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUBMITTED PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH HAS NOT BEEN INVESTIGATED OR VERIFIED PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY DEPUY SYNTHESE, OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE PRODUCT, DEPUY SYNTHESE, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE. THE ACTUAL DEVICE HAS BEEN RETURNED AND IS CURRENTLY PENDING EVALUATION. ONCE THE DEVICE HAS BEEN EVALUATED, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SENT ACCORDINGLY.

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUBMITTED PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION, WHICH HAS NOT BEEN INVESTIGATED OR VERIFIED PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY DEPUY SYNTHES JOINT RECONSTRUCTION, OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE PRODUCT, DEPUY SYNTHES JOINT RECONSTRUCTION, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED, THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE. INVESTIGATION SUMMARY: THE ACTUAL DEVICE WAS RETURNED FOR EVALUATION. DURING EVALUATION, IT WAS DETERMINED, THAT THE DESCRIBED FAILURE BY THE USER WAS CONFIRMED. THE ASSIGNABLE ROOT CAUSE COULD NOT BE DETERMINED. THE ISSUE REPORTED REGARDING THE LOOSE CONNECTION HAS BEEN ESCALATED TO A CAPA. REVIEW OF THE DEVICE HISTORY RECORD(S) SHOWED, THAT THERE WERE NO ISSUES, DURING THE INSTALLATION OF THIS PRODUCT. WHICH, WOULD CONTRIBUTE TO THIS COMPLAINT CONDITION.

Description of Event or Problem · 0

THIS IS REPORT 1 OF 2 FOR THE SAME EVENT. IT WAS REPORTED THAT DURING PRE-SURGERY THAT ROBOTIC ASSISTED SAW HANDPIECE DEVICE HAD A LOT OF PLAY WHERE IT ATTACHED TO THE SAW INTERFACE RIGHT. IT WAS REPORTED THAT REPLACEMENT OF THE SAW DEVICE AND SAW INTERFACE RIGHT DEVICE RESOLVED THE ISSUE. THIS EVENT DID NOT OCCUR DURING SURGERY. THERE WAS NO PATIENT INVOLVEMENT. THERE WERE NO REPORTS OF INJURIES, MEDICAL INTERVENTION OR PROLONGED HOSPITALIZATION. ALL AVAILABLE INFORMATION HAS BEEN DISCLOSED. IF ADDITIONAL INFORMATION SHOULD BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED ACCORDINGLY.

Description of Event or Problem · 0

THIS IS REPORT 1 OF 2 FOR THE SAME EVENT. IT WAS REPORTED THAT DURING PRE-SURGERY THAT ROBOTIC ASSISTED SAW HANDPIECE DEVICE HAD A LOT OF PLAY WHERE IT ATTACHED TO THE SAW INTERFACE RIGHT. IT WAS REPORTED THAT REPLACEMENT OF THE SAW DEVICE AND SAW INTERFACE RIGHT DEVICE RESOLVED THE ISSUE. THIS EVENT DID NOT OCCUR DURING SURGERY. THERE WAS NO PATIENT INVOLVEMENT. THERE WERE NO REPORTS OF INJURIES, MEDICAL INTERVENTION OR PROLONGED HOSPITALIZATION. ALL AVAILABLE INFORMATION HAS BEEN DISCLOSED. IF ADDITIONAL INFORMATION SHOULD BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED ACCORDINGLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
9306 VELYS SAW HANDPIECE ORTHOPEDIC STEREOTAXIC INSTRUMENT OLO DEPUY IRELAND UC 4515-70-102 10603295519430

Patients

Seq Age Sex Outcome Treatment
1 Unknown