FDA Adverse Event Malfunction Summary report: N

KIM DOUBLE CHOPPER

MDR report key: 21951426 · Received May 2, 2025

Report

Report Number
2242450-2025-00005
Event Type
Malfunction
Date Received
May 2, 2025
Date of Event
March 10, 2025
Report Date
June 3, 2025
Manufacturer
KATENA PRODUCTS INC.
Product Code
HND
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PL
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE REPORTER STATED THAT THE INSTRUMENTS WILL BE RETURNED TO KATENA FOR EVALUATION. AT THE TIME OF THIS REPORT, NO INSTRUMENTS HAVE BEEN RETURNED.

Additional Manufacturer Narrative · 0

THIS FOLLOW UP IS BEING SUBMITTED AS AN UPDATE FOR 2242450-2025-00005 (KIM DOUBLE CHOPPER K3-2335, LOT L2405J000056218). UPDATE FROM THE SURGEON INDICATES THAT THE INSTRUMENTS FAILED IN TWO SEPARATE PROCEDURES. AS OF 03-JUN-2025, NO INSTRUMENTS HAVE BEEN RECEIVED BY KATENA FOR EVALUATION. CORZA HAS MADE MULTIPLE ATTEMPTS TO RETRIEVE THE INSTRUMENTS. REVIEW OF PAST COMPLAINTS AGAINST K3-2335 INDICATES THAT THIS IS THE 6TH COMPLAINT TOTAL AGAINST THIS PRODUCT. THIS IS THE 5TH COMPLAINT CLAIMING THAT THE INSTRUMENT BROKE. THERE WERE (B)(4) UNITS MANUFACTURED IN THIS LOT. THIS IS THE FIRST COMPLAINT REPORTED AGAINST THIS LOT.

Description of Event or Problem · 0

ON 03-APR-2025, A DISTRIBUTOR FROM POLAND INFORMED KATENA PRODUCTS INC. (A CORZA MEDICAL COMPANY) CUSTOMER SERVICE REPRESENTATIVE THAT SHE RECEIVED A COMPLAINT FROM ONE OF THEIR CUSTOMERS AGAINST K3-2335 KIM DOUBLE CHOPPER FROM KATENA. THEIR CUSTOMER RETURNED THREE (3) UNITS TO THE DISTRIBUTOR CLAIMING THAT THE TIP OF THE INSTRUMENTS ARE BREAKING WHILE MANIPULATING IN THE EYE DURING CATARACT SURGERY. THE REPORTER STATED THAT THE INCIDENT OCCURRED ON (B)(6) 2025. THE INSTRUMENTS' LOTS ARE L2411J00006477, L2406J000057382, L2405J000056218. THE DISTRIBUTOR ALSO STATED THAT THEIR CUSTOMER IS IN POSSESSION OF TWO (2) MORE INSTRUMENTS WHERE A SIMILAR INCIDENT OCCURED, HOWEVER THERE WERE NO LOT NUMBERS OR ADDITIONAL DETAILS PROVIDED. THERE WERE NO INJURIES OR HARM TO THE PATIENT. THE BROKEN PIECE WAS "GENTLY REMOVED" ACCORDING TO THE REPORTER OF THE INCIDENT. ADDITIONAL INFORMATION WAS REQUESTED FROM THE DISTRIBUTOR AND DOCTOR INVOLVED. KATENA REQUESTED THAT THE INSTRUMENTS BE SENT BACK TO (B)(6), NJ FOR A FULL INVESTIGATION. NO ITEMS HAVE BEEN RECEIVED AT THE TIME OF THIS REPORT. 4 INDIVIDUAL REPORTS WILL BE SUBMITTED TO CAPTURE INSTRUMENT LOTS L2411J00006477, L2406J000057382, L2405J000056218, AND UNKNOWN LOT AS IT IS UNCLEAR HOW MANY INCIDENTS OR PATIENTS INVOLVING THE INSTRUMENTS OCCURED. THIS REPORT IS INTENDED TO CAPTURE LOT L2405J000056218.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
189605 KIM DOUBLE CHOPPER SPATULA, OPHTHALMIC HND KATENA PRODUCTS INC. K3-2335 L2405J000056218

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown