FDA Adverse Event Malfunction Summary report: N

ATTUNE REV CONV CUT GUIDE SZ 7

MDR report key: 17187707 · Received June 22, 2023

Report

Report Number
1818910-2023-12806
Event Type
Malfunction
Date Received
June 22, 2023
Date of Event
June 15, 2023
Report Date
June 22, 2023
Manufacturer
DEPUY IRELAND - 9616671
Product Code
HTZ
UDI-DI
10603295438465
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT # (B)(4). DEPUY SYNTHES IS SUBMITTING THIS REPORT PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH DEPUY SYNTHES HAS NOT BEEN ABLE TO INVESTIGATE OR VERIFY PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY FDA, DEPUY SYNTHES OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE DEVICE, DEPUY SYNTHES, 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 MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT (B)(4). INVESTIGATION SUMMARY: AN ANALYSIS OF THE PRODUCT COULD NOT BE PERFORMED, SINCE A PHYSICAL SAMPLE WAS NOT RECEIVED FOR EVALUATION. AS PART OF OUR COMPANY QUALITY SYSTEM PROCESS, ALL DEVICES ARE MANUFACTURED, INSPECTED, AND DISTRIBUTED TO APPROVED SPECIFICATIONS. ADDITIONAL COMPLAINT INFORMATION, MONITORING FOR POTENTIAL SAFETY SIGNALS WILL BE CONDUCTED THROUGH COMPLAINT TRENDING AS PART OF THE POST-MARKET SURVEILLANCE. HOWEVER, IF THE PRODUCT IS RECEIVED AT A LATER DATE, THE INVESTIGATION WILL BE UPDATED AS APPLICABLE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE CUT BLOCK WAS JUMPING ON HIS POSTERIOR CHAMFER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1865397 ATTUNE REV CONV CUT GUIDE SZ 7 RESECTION BLOCKS/DEVICES HTZ DEPUY IRELAND - 9616671 2504-40-607 ABG08246 10603295438465

Patients

Seq Age Sex Outcome Treatment
1 Unknown