BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    4MM EXTRA COARSE DIAMOND BALL

    MDR report key: 3726698 · Received November 27, 2013

    Report

    Report Number
    1045834-2013-11648
    Event Type
    Malfunction
    Date Received
    November 27, 2013
    Date of Event
    August 10, 2012
    Report Date
    August 17, 2012
    Manufacturer
    DEPUY SYNTHES POWER TOOLS
    Product Code
    HBC
    PMA / PMN Number
    K011444
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE WAS REC'D BY DEPUY SYNTHES POWER TOOLS. THE DEVICE WAS EVALUATED AND THE CUSTOMER'S COMPLAINT OF PACKAGING DEFECTS COULD NOT BE CONFIRMED. VISUAL INSPECTION ACCEPTANCE CRITERIA ARE "NO LOOSE FOREIGN MATERIAL (LFM) WHEN INSPECTED AT 1X MAGNIFICATION." NO LFM COULD BE FOUND ON DEVICE WHEN INSPECTED AT 10X MAGNIFICATION. ALSO, THE PACKAGE IS IN GOOD CONDITION WITH NO DEFECTS OF THE PEELABLE OR TERMINAL SEAL. IF ADD'L INFO BECOMES AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4).

    Description of Event or Problem · 1

    REPORT REC'D FROM (B)(6) STATING "DEBRIS IS STERILE PACKAGE" IT IS KNOWN THAT THIS EVENT DID NOT OCCUR DURING SURGERY AND THAT THERE WAS NO PATIENT/USER INJURY OR MEDICAL INTERVENTION. THERE WAS NO ADD'L INFO PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    619474 4MM EXTRA COARSE DIAMOND BALL HBC DEPUY SYNTHES POWER TOOLS E303053432

    Patients

    Seq Age Sex Outcome Treatment
    1