FDA Adverse Event Malfunction Summary report: N

ANGLED REAMER, DRIVE SHAFT

MDR report key: 19450341 · Received June 3, 2024

Report

Report Number
1220246-2024-04763
Event Type
Malfunction
Date Received
June 3, 2024
Date of Event
April 12, 2023
Report Date
June 3, 2024
Manufacturer
ARTHREX, INC.
Product Code
LXH
UDI-DI
00888867324954
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

THIS 3500A RECORD IS SUBMITTED TO COMPLY WITH AN FDA 483 INSPECTIONAL OBSERVATION ISSUED TO ARTHREX INC ON MAY 5, 2023.  ARTHREX HAS REASSESSED THE REPORTABILITY DECISIONS MADE ON HISTORICAL COMPLAINT RECORDS USING REVISED CRITERION. THIS 3500A DOCUMENT IS A RESULT OF THE REASSESSMENT. THE COMPLAINT IS CONFIRMED. ONE UNPACKAGED AR-9676 SERIAL/BATCH NUMBER (B)(6) WAS RECEIVED FOR INVESTIGATION. FUNCTIONAL TESTING WITH THE RETURNED MATTING PART AR-9597-10, BATCH 37222223 FOUND RESISTANCE AND FRICTION. BOTH DEVICES ARRIVE SEPARATELY FOR INVESTIGATION. THE VISUAL EVALUATION REVEALED HEAVY SCRATCHES AND LINES. THE MOST LIKELY CAUSE FOR THE REPORTED FAILURE CAN BE ATTRIBUTED TO USER-APPLIED EXCESSIVE FORCE DURING THE TIGHTENING PROCESS.

Description of Event or Problem · 0

ON 04/12/2023, IT WAS REPORTED BY A SALES REPRESENTATIVE VIA (B)(4) THAT AN AR-9676 DRIVE SHAFT GOT STUCK IN AN AR-9597-10 DRILL SLEEVE. THIS WAS DISCOVERED DURING A CASE WITH NO PATIENT EFFECT. PER FACILITY: "THE AUGMENTED UNIVERS VAULTLOCK GLENOID ANGLED REAMER SLEEVE, 15° DEFECT (AR-9579-10 #(10)37222223 HAS BEEN COMPROMISED. THE ANGLED REAMER INNER DRIVE SHAFT AR-9676 LOT#(10)022239 (WHICH IS NOW ALSO COMPROMISED) REQUIRED FORCE TO BE EXTRACTED FROM AR-9579-10. THERE WAS NOT A DELAY DURING THE PROCEDURE AND THE PATIENT WILL NOT REQUIRE ANOTHER PROCEDURE."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
611565 ANGLED REAMER, DRIVE SHAFT MANUAL INSTR, GENERAL SURGICAL LXH ARTHREX, INC. ANGLED REAMER, DRIVE SHAFT 022239 00888867324954

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown