BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    QUICKSET 1PC FLEX DRILL BIT 25

    MDR report key: 3890668 · Received June 24, 2014

    Report

    Report Number
    1818910-2014-21793
    Event Type
    Malfunction
    Date Received
    June 24, 2014
    Date of Event
    June 3, 2014
    Report Date
    June 3, 2014
    Manufacturer
    DEPUY ORTHOPAEDICS, INC. 1818910
    Product Code
    LXH
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WI, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

    Additional Manufacturer Narrative · 1

    THE DEVICE ASSOCIATED WITH THIS REPORT WAS NOT RETURNED. THE INITIAL REPORT STATED THE DEVICE WOULD NOT BE RETURNED. A COMPLAINT DATABASE SEARCH HAS IDENTIFIED A TREND FOR THIS FAILURE WITHIN THE 2274 QUICKSET DRILL FAMILY. PREVIOUS INVESTIGATIONS HAVE DETERMINED THAT USE ERROR IS THE LIKELY ROOT CAUSE. AS A RESULT OF TRENDING HEALTH HAZARD EVALUATION, DVA-106292-HHE WAS CONDUCTED. THE INVESTIGATION DID NOT ESTABLISH THE NEED FOR CORRECTIVE ACTION. NO EVIDENCE WAS FOUND OF PRODUCT OR DESIGN ERROR AS A CONTRIBUTING FACTOR. SUBSEQUENT COMPLAINTS WILL BE MONITORED UNDER SEP 419 POST MARKET SURVEILLANCE.

    Description of Event or Problem · 1

    WHILE PREPARING SHELL FOR A SCREW, A 25 MM FLEX BIT BROKE OFF IN ACETABULUM AND WAS UNRETRIEVABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    368271 QUICKSET 1PC FLEX DRILL BIT 25 HIP INSTRUMENT/TRIAL LXH DEPUY ORTHOPAEDICS, INC. 1818910 PG121012

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR