BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    6MM FLUTED ACORN

    MDR report key: 3240435 · Received July 17, 2013

    Report

    Report Number
    1045834-2013-03390
    Event Type
    Malfunction
    Date Received
    July 17, 2013
    Date of Event
    June 1, 2013
    Report Date
    June 17, 2013
    Manufacturer
    DEPUY SYNTHES POWER TOOLS
    Product Code
    HBC
    PMA / PMN Number
    K011444
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SZ
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    AS OF THIS DATE, THE DEVICE HAS NOT BEEN RETURNED FOR EVAL; THEREFORE, THE REPORTED CONDITION CANNOT BE CONFIRMED AND/OR DUPLICATED. IF ADD'L INFO SHOULD BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SENT ACCORDINGLY.

    Description of Event or Problem · 1

    IT WAS REPORTED FROM (B)(6) THAT DURING INCOMING INSPECTION, IT WAS OBSERVED THAT THERE WAS "RESIDUE IN THE STERILE PACKAGE" OF THE DEVICE. THE DEVICE WAS NOT USED IN SURGERY. NO INJURIES OF MEDICAL INTERVENTION WERE REPORTED. THE EXACT DATE OF THE EVENT WAS UNK. ALTHOUGH THE REPORTER CLARIFIED THE EVENT OCCURRED IN (B)(6) 2013. ALL AVAILABLE INFO HAS BEEN DISCLOSED. IF ADD'L INFO SHOULD BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SUBMITTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    331800 6MM FLUTED ACORN HBC DEPUY SYNTHES POWER TOOLS F496012470

    Patients

    Seq Age Sex Outcome Treatment
    1