FDA Adverse Event Injury Summary report: N

4MM FLUTED BALL

MDR report key: 3771077 · Received April 24, 2014

Report

Report Number
1045834-2014-11838
Event Type
Injury
Date Received
April 24, 2014
Date of Event
April 1, 2014
Report Date
April 1, 2014
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
HBC
PMA / PMN Number
PK011444
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AS OF THIS DATE, THE DEVICE HAS NOT BEEN RETURNED FOR EVALUATION; THEREFORE, THE REPORTED CONDITION CANNOT BE CONFIRMED AND/OR DUPLICATED. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

THE ACTUAL DEVICE WAS RETURNED FOR EVALUATION. RELIABILITY ENGINEERING EVALUATED THE DEVICE AND THE REPORTED CONDITION WAS NOT DUPLICATED OR CONFIRMED. THEREFORE, AN ASSIGNABLE ROOT CAUSE WAS NOT DETERMINED. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

THIS IS REPORT 3 OF 4 OF THE SAME EVENT. IT WAS REPORTED THAT DURING AN UNSPECIFIED FOOT SURGERY, IT WAS OBSERVED THAT THE MOTOR DEVICE, ATTACHMENT DEVICE AND CUTTER DEVICE ¿WERE MAKING FUNNY NOISES AND METAL SHAVINGS WERE FALLING INTO THE SURGICAL SITE¿ WHEN IN USE TOGETHER. THE REPORTER STATED THAT THE MOTOR DEVICE WAS SWITCHED WITH A SPARE MOTOR DEVICE. THE SAME ATTACHMENT DEVICE AND CUTTER DEVICE WERE UTILIZED WITH THE SPARE MOTOR DEVICE. ACCORDING TO THE REPORT, IT WAS AGAIN OBSERVED THAT THE DEVICES WERE MAKING FUNNY NOISES AND METAL SHAVINGS WERE FALLING INTO THE SURGICAL SITE¿. AS A RESULT, THERE WAS A FIVE MINUTE DELAY TO THE SURGICAL PROCEDURE. THERE WAS PATIENT INVOLVEMENT. THERE WERE NO REPORTS OF INJURIES OR PROLONGED HOSPITALIZATION. IT WAS UNKNOWN TO THE REPORTER IF RADIOLOGY IMAGING WAS UTILIZED. ALL AVAILABLE INFORMATION HAS BEEN DISCLOSED. IF ADDITIONAL INFORMATION SHOULD BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SUBMITTED ACCORDINGLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
249593 4MM FLUTED BALL MOTOR, DRILL, ELECTRIC - CUTTING BURR HBC DEPUY SYNTHES POWER TOOLS F023060230

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention ATTACHMENT DEVICE| MOTOR DEVICE| MOTOR DEVICE