FDA Adverse Event Malfunction Summary report: N

ANGLED REAMER, DRIVE SHAFT

MDR report key: 20695280 · Received November 15, 2024

Report

Report Number
1220246-2024-08546
Event Type
Malfunction
Date Received
November 15, 2024
Date of Event
November 7, 2024
Report Date
January 28, 2025
Manufacturer
ARTHREX, INC.
Product Code
LXH
UDI-DI
00888867324954
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: D9, G3, H3, H6. THE COMPLAINT ALLEGATION IS CONFIRMED. ONE UNPACKAGED AR-9676 SERIAL/BATCH NUMBER 022339 WAS RECEIVED FOR INVESTIGATION. FUNCTIONAL TESTING WITH THE RETURNED MATTING PART AR-9597-10, BATCH 1037622109 FOUND RESISTANCE AND FRICTION. THE VISUAL EVALUATION REVEALED HEAVY SCRATCHES AND LINES AT THE DISTAL AND PROXIMAL END CONSISTENT WITH SIGNS OF FRICTION. THE MOST LIKELY CAUSE FOR THE REPORTED FAILURE CAN BE ATTRIBUTED TO MISUSE DUE TO INTERFERENCE WITH THE MATING INSTRUMENT.

Additional Manufacturer Narrative · 0

INVESTIGATION IS IN PROCESS. A FOLLOW-UP REPORT WILL BE PROVIDED UPON AVAILABILITY OF ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: B5, G3, H6.

Description of Event or Problem · 0

ON 11/07/2024, IT WAS REPORTED BY A SALES REPRESENTATIVE VIA (B)(4). THAT AN AR-9676 ANGLED REAMER DRIVE SHAFT COLD WELDED TO THE SLEEVE AND BECAME STUCK. THIS OCCURRED DURING USE IN A CASE WITH NO PATIENT EFFECT. ADDITIONAL INFORMATION REQUESTED.

Description of Event or Problem · 0

THE CASE WAS COMPLETED BY DISASSEMBLING THE DEVICES AND REASSEMBLING THEM. 5 MINUTE DELAY TO CASE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1306727 ANGLED REAMER, DRIVE SHAFT MANUAL INSTR, GENERAL SURGICAL LXH ARTHREX, INC. ANGLED REAMER, DRIVE SHAFT 022339 00888867324954

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown