FDA Adverse Event Malfunction Summary report: N

CORTSCR Ø4.5 SELF-TAP L42 SST

MDR report key: 3187899 · Received June 25, 2013

Report

Report Number
8030965-2013-04072
Event Type
Malfunction
Date Received
June 25, 2013
Date of Event
May 8, 2012
Report Date
May 8, 2012
Manufacturer
SYNTHES GMBH
Product Code
HWC
PMA / PMN Number
K112583
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FI
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SYNTHES IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO FDA WARNING LETTER DATED FEBRUARY 2012. DEVICE(S) LISTED IN THIS REPORT IS (ARE) USED FOR TREATMENT, NOT DIAGNOSIS. ANY ADDITIONAL INFORMATION RECEIVED REGARDING THIS EVENT AFTER FILING THIS REPORT SHALL BE FILED ON A SUPPLEMENTAL MDR. A REVIEW OF THE DEVICE HISTORY RECORDS HAS BEEN REQUESTED. THE VISUAL INSPECTION AND INVESTIGATION HAS SHOWN THAT THESE ARTICLES HAVE BEEN LABELED INCORRECTLY. THE LABEL SAYS 208.050 / 7755662 BUT IT SHOULD BE 214.742 / 7759050. OBVIOUSLY THIS PACKAGE PASSED THE LABELING PROCEDURE DURING MANUFACTURING PROCESS WITHOUT HAVING GONE THROUGH PROPER CONTROL. THIS COMPLAINT HAS BEEN DETERMINED TO BE VALID. A CAPA DETERMINATION REQUEST HAS BEEN INITIATED. (B)(6).

Additional Manufacturer Narrative · 1

SYNTHES IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO FDA WARNING LETTER DATED FEBRUARY 2012. DEVICE(S) LISTED IN THIS REPORT IS (ARE) USED FOR TREATMENT, NOT DIAGNOSIS. ANY ADDITIONAL INFORMATION RECEIVED REGARDING THIS EVENT AFTER FILING THIS REPORT SHALL BE FILED ON A SUPPLEMENTAL MDR. MANUFACTURING DOCUMENTS WERE REVIEWED AND NO COMPLAINT RELATED ISSUES WERE FOUND. PLACEHOLDER.

Description of Event or Problem · 1

LABEL IS 2083050 MATERIAL IS 214.842. THIS IS 2 OF 3 REPORTS FOR THIS COMPLAINT (B)(4).

Description of Event or Problem · 1

LABEL IS 208.050 MATERIAL IS 214.842.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
287570 CORTSCR Ø4.5 SELF-TAP L42 SST HWC SYNTHES GMBH 7759050

Patients

Seq Age Sex Outcome Treatment
1