BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    KERRISON DETACH.130DEG UP 200MM 3MM THIN

    MDR report key: 19239826 · Received May 3, 2024

    Report

    Report Number
    9610612-2024-00160
    Event Type
    Malfunction
    Date Received
    May 3, 2024
    Date of Event
    November 8, 2023
    Report Date
    May 3, 2024
    Manufacturer
    AESCULAP AG
    Product Code
    GXJ
    PMA / PMN Number
    EXEMPT
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    ADDITIONAL REPORTER: (B)(6). INVESTIGATION RESULTS: THE VISUAL INSPECTION REVEALED A DEFORMED CUTTING PART OF THE WANGLER. FURTHER ANALYSES OF THIS ERROR PATTERN WERE CARRIED OUT AS PART OF AESCULAP AG INTERNAL REFERENCE NO. (B)(4). THE REPEATING FAILURE MODE WAS CONFIRMED BASED ON THE RECEIVED SAMPLE FAILURE DESCRIPTION AND BASED ON PHOTO DOCUMENTATION. BATCH HISTORY REVIEW: THE DEVICE QUALITY AND MANUFACTURING HISTORY RECORDS HAVE BEEN CHECKED FOR ALL AVAILABLE LOT NUMBERS AND THE PRODUCTS FOUND TO BE ACCORDING TO SPECIFICATION VALID AT THE TIME OF PRODUCTION. THERE ARE NO SIMILAR COMPLAINTS AGAINST THE SAME LOT NUMBER(S) WITH THIS ERROR PATTERN. THIS MEDWATCH IS BEEING SENT AS A FEEDBACK TO THE FDA IN REFERENCE TO THE MEDWATCH: 2400930000-2023-8024 ACCORDING TO MANUFACTURER'S REPORTING EVALUATION IN ACCORDANCE WITH 21 CFR PART 803, SECTION 803.3 AND 803.50, THIS EVENT IS NOT CONSIDERED / DEEMED AS A REPORTABLE EVENT FOR THE FOLLOWING REASON: - NO DEATH OR SERIOUS INJURY - NO MALFUNCTION THAT WOULD BE LIKELY TO CAUSE OR CONTRIBUTE TO A DEATH OR SERIOUS INJURY, IF THE MALFUNCTION WERE TO RECUR THE REPORTING DECISION IS BASED UPON THE REVIEW OF THE APPLICABLE RISK ANALYSIS. THE REVIEW OF THE RISK ANALYSIS REVEALED THAT THE APPLICABLE FAILURE MODE IS RATED WITH A SEVERITY OF 1(5). BASED UPON RISK MANAGEMENT REVIEW, WE CURRENTLY CONCLUDE THAT EVEN IF THE REPORTED FAILURE IS TO REOCCUR, NO SERIOUS INJURY FOR PATIENT, USER OR THIRD PARTY IS TO BE EXPECTED. CONCLUSION/PREVENTIVE MEASURES: THE REPORTED DAMAGE OF THE PRODUCT COULD BE CONFIRMED. A FINAL ROOT CAUSE FOR THIS FAILURE COULD NOT BE DETERMINED. BASED ON CONTINUOUS IMPROVEMENT, A OPTIMIZED CHANGE IN DESIGN WAS MADE.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT THERE WAS AN ISSUE WITH THE PRODUCT FK963R - KERRISON DETACH.130DEG UP 200MM 3MM THIN VIA INFORMATION RECEIVED FROM MW 2400930000-2023-8024. ACCORDING TO THE COMPLAINT DESCRIPTION, THE DEVICE WAS BENDING DURING USE (TOP SLIDER PORTION). THIS OCCURRED DURING SPINAL SURGERY. A DIFFERENT KERRISON WAS USED TO COMPLETE THE PROCEDURE. FURTHER DETAILS WERE NOT PROVIDED. THE MALFUNCTION IS FILED UNDER AESCULAP AG REFERENCE NO. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1306179 KERRISON DETACH.130DEG UP 200MM 3MM THIN BONE PUNCHES, RONGEURS GXJ AESCULAP AG FK963R 4514130040

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Unknown