FDA Adverse Event Malfunction Summary report: N

3MM FLUTED MATCHSTICK

MDR report key: 3967039 · Received December 9, 2013

Report

Report Number
1045834-2013-10541
Event Type
Malfunction
Date Received
December 9, 2013
Date of Event
August 10, 2012
Report Date
August 16, 2012
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
GFF
PMA / PMN Number
K974025
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 DEVICE WHEN INSPECTED AT 10X MAGNIFICATION. ALSO, THE PACKAGE IS IN GOOD CONDITION WITH NO DEFECTS OF THE PEELABLE OR TERMINAL SEAL. IF ADDITIONAL INFO BECOMES AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4).

Description of Event or Problem · 1

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 ADDITIONAL INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
639722 3MM FLUTED MATCHSTICK GFF DEPUY SYNTHES POWER TOOLS E493058943

Patients

Seq Age Sex Outcome Treatment
1