FDA Adverse Event Malfunction Summary report: N

SUPER SUCKER SHORT CURVED (BX/20)

MDR report key: 3966880 · Received December 9, 2013

Report

Report Number
1045834-2013-14486
Event Type
Malfunction
Date Received
December 9, 2013
Date of Event
August 10, 2012
Report Date
August 15, 2012
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
KDC
PMA / PMN Number
K822065
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RECEIVED 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 THE 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.

Description of Event or Problem · 1

REPORT 8 OF 25. REPORT RECEIVED FROM (B)(6) STATING THE DEVICE "FAILED DISTRIBUTOR'S INSPECTION." IT IS KNOWN THAT THIS EVENT DID NOT OCCUR DURING SURGERY AND THAT THERE WAS NO PT/USER INJURY OR MEDICAL INTERVENTION. THERE WAS NO ADD'L INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
637990 SUPER SUCKER SHORT CURVED (BX/20) KDC DEPUY SYNTHES POWER TOOLS F073061273

Patients

Seq Age Sex Outcome Treatment
1