FDA Adverse Event Malfunction Summary report: N

ANGLED REAMER SLEEVE, 10°

MDR report key: 18935978 · Received March 19, 2024

Report

Report Number
1220246-2024-01558
Event Type
Malfunction
Date Received
March 19, 2024
Date of Event
March 5, 2024
Report Date
December 2, 2024
Manufacturer
ARTHREX, INC.
Product Code
LXH
UDI-DI
00888867343436
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

THE CONTRIBUTION OF THE DEVICE TO THE REPORTED EVENT COULD NOT BE DETERMINED AS THE DEVICE WAS NOT RETURNED FOR EVALUATION. INVESTIGATION IS IN PROCESS. A FOLLOW-UP REPORT WILL BE PROVIDED UPON AVAILABILITY OF ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: D9, G3, H3, H6. ONE UNPACKAGED AR-9597-20 ANGLED REAMER SLEEVE BATCH NUMBER: 37622247 WAS RECEIVED FOR INVESTIGATION. THE MATING PART AR-9676 ANGLED REAMER DRIVESHAFT BATCH NUMBER: 022339 WAS RECEIVED SEPARATELY FROM THE ANGLED REAMER SLEEVE. UPON VISUAL INVESTIGATION, IT WAS NOTED THAT THE AR-9597-20 HAD STRIATIONS ALONG THE COLLAR. A MOST LIKELY CAUSE FOR THIS FAILURE CAN BE ATTRIBUTED TO WEAR AND TEAR INCURRED OVER REPEATED USAGE. FUNCTIONAL TESTING WAS PERFORMED WITH THE AR-9676 BATCH NUMBER: 022339 AND IT WAS NOTED THAT THE MATING PART WAS ABLE TO ATTACH AND DETACH FROM THE AR-9597-20 ANGLED REAMER SLEEVE EASILY. NO PROBLEM FOUND. REFER TO INVESTIGATION PHOTOS. COMPLAINT WAS NOT CONFIRMED.

Description of Event or Problem · 0

ON 03/05/2024, IT WAS REPORTED BY A SALES REPRESENTATIVE VIA (B)(4) THAT AN AR-9597-10 REAMER SLEEVE AND AR-9676 REAMER SHAFT ARE STUCK. THIS OCCURRED AFTER USE IN A CASE WITH NO PATIENT EFFECT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
589326 ANGLED REAMER SLEEVE, 10° MANUAL INSTR, GENERAL SURGICAL LXH ARTHREX, INC. ANGLED REAMER SLEEVE, 10° 37622247 00888867343436

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown