FDA Adverse Event Malfunction Summary report: N

8 CM SHORT,QD ANGLE ATTACHMENT

MDR report key: 3980191 · Received August 5, 2014

Report

Report Number
1045834-2014-12557
Event Type
Malfunction
Date Received
August 5, 2014
Date of Event
July 23, 2014
Report Date
July 23, 2014
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
HBC
PMA / PMN Number
PK133604
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS PROVIDED BY THE REPORTER STATING THAT THE PROCEDURE WAS COMPLETED SUCCESSFULLY. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE , A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

(B)(6). THE REPORTER STATED THAT THE DEVICE WILL NOT BE RETURNED FOR INVESTIGATION. 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

DURING SUBSEQUENT FOLLOW-UP WITH THE REPORTER, ADDITIONAL INFORMATION WAS RECEIVED. THE REPORTER STATED THAT THE EVENT OCCUR DURING THE INTERVENTION. THE ISSUE WAS SOLVED BY WAITING AND THE PROCEDURE WAS ENDED AFTER THE ONE SPINAL LEVEL. ALL AVAILABLE INFORMATION HAS BEEN DISCLOSED. IF ADDITIONAL INFORMATION SHOULD BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SUBMITTED ACCORDINGLY.

Description of Event or Problem · 1

THIS IS REPORT 1 OF 2 FOR THE SAME EVENT: IT WAS REPORTED FROM (B)(6) THAT DURING AN UNSPECIFIED SURGICAL PROCEDURE, IT WAS OBSERVED THAT THE ATTACHMENT DEVICE BECAME HOT WITHIN 30 AND 40 SECONDS WHEN IN USE WITH A CUTTER DEVICE. ACCORDING TO THE REPORT, ¿THE MARKS OF THE BEARINGS WERE VISIBLE AFTER USE¿. THE REPORTER STATED THAT THE ATTACHMENT DEVICE WAS ¿BRAND NEW¿. ACCORDING TO THE REPORTER, THERE WAS NO UNUSUAL HANDLING MADE DURING THE INTERVENTION AND ¿REPROCESSING AS THE HOSPITAL ALREADY USED AND CLEANED¿ THE SYSTEM FOR MORE THAN THREE MONTHS. THERE WERE NO DELAYS TO THE SURGICAL PROCEDURE. HOWEVER, IT WAS UNKNOWN IF A SPARE DEVICE WAS AVAILABLE FOR USE. THERE WAS PATIENT INVOLVEMENT. THE REPORTER INDICATED THAT THE PRODUCT OCCURRENCE WAS NOT RELEVANT TO THE HEALTH OF PATIENT. THERE WERE NO REPORTS OF INJURIES, MEDICAL INTERVENTION OR PROLONGED HOSPITALIZATION. 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
458357 8 CM SHORT,QD ANGLE ATTACHMENT MOTOR, DRILL, ELECTRIC - ATTACHMENT HBC DEPUY SYNTHES POWER TOOLS NA

Patients

Seq Age Sex Outcome Treatment
1 MOTOR DEVICE| CUTTER DEVICE