FDA Adverse Event Malfunction Summary report: N

DISPOSABLE SMALL JOI

MDR report key: 2101229 · Received May 24, 2011

Report

Report Number
1219602-2011-00085
Event Type
Malfunction
Date Received
May 24, 2011
Date of Event
April 29, 2011
Report Date
April 29, 2011
Manufacturer
SMITH & NEPHEW ENDOSOCPY MANSFIELD MANUFACTURE
Product Code
HAB
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

METAL SHAVINGS APPEARED IN THE JOINT WHEN THE BLADE WAS INSERTED INTO THE JOINT AND TURNED ON BUT BEFORE ANY TISSUE WAS RESECTED. SURGEON STATED HE FELT THAT DEBRIS, REMAINING FROM THE MANUFACTURING PROCESS WAS THE POSSIBLE SOURCE OF THE SHAVINGS. SURGEON FLUSHED JOINT OF AS MUCH AS POSSIBLE BUT SOME METAL DEBRIS REMAINED. SURGEON CONCERNED AND UPSET AS HE CANNOT TAKE AN MRI OF THIS PATIENTS WRIST IN THE FUTURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DISPOSABLE SMALL JOI FULL RADIUS,2.9,DSP,MINI BLD(6 HAB SMITH & NEPHEW ENDOSOCPY MANSFIELD MANUFACTURE 3419 50552792

Patients

Seq Age Sex Outcome Treatment
1