ANGLED REAMER, DRIVE SHAFT
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
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.
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 |