FDA Adverse Event Malfunction Summary report: N

IRRIG CLIP, MED, LONG/-S, TURQ-L

MDR report key: 3240468 · Received July 17, 2013

Report

Report Number
1045834-2013-03403
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
FRN
PMA / PMN Number
K030576
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 ADDITIONAL 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 OR 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 ADDITIONAL INFO SHOULD BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SUBMITTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
332770 IRRIG CLIP, MED, LONG/-S, TURQ-L FRN DEPUY SYNTHES POWER TOOLS F533072964

Patients

Seq Age Sex Outcome Treatment
1