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 |