BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VELYS SAW INTERFACE RIGHT

    MDR report key: 13562387 · Received February 18, 2022

    Report

    Report Number
    1818910-2022-03047
    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
    10603295519478
    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, ROBOTIC ASSISTED SAW HANDPIECE DEVICE, (B)(6) 2022. UDI: (B)(4).

    Additional Manufacturer Narrative · 0

    PRODUCT COMPLAINT (B)(4). INVESTIGATION SUMMARY: AFTER MULTIPLE REQUESTS, THE CUSTOMER HAS NOT RETURNED THE DEVICE FOR EVALUATION / REPAIR TO ANY JNJ SITE AND THEREFORE THE COMPLAINT CANNOT BE CONFIRMED, AND NO CONCLUSION CAN BE DRAWN AT THIS TIME. THE COMPLAINT WILL BE REOPENED UPON RECEIVING THE DEVICE FOR REPAIR FROM THE CUSTOMER. DEVICE HISTORY LOT: THE PRODUCT INVESTIGATION FOUND NO EVIDENCE SUSPECTING AN ERROR IN THE MANUFACTURING OR MATERIAL THAT WOULD BE A CONTRIBUTING FACTOR IN THE REPORTED ALLEGATION(S). A MANUFACTURING RECORDS EVALUATION (MRE) WAS NOT PERFORMED.

    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.

    Description of Event or Problem · 0

    THIS IS REPORT 2 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
    9312 VELYS SAW INTERFACE RIGHT ORTHOPEDIC STEREOTAXIC INSTRUMENT OLO DEPUY IRELAND UC 4515-70-106 J44455 10603295519478

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown