BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    4MM FLUTED BALL

    MDR report key: 3981463 · Received December 18, 2013

    Report

    Report Number
    1045834-2013-16161
    Event Type
    Malfunction
    Date Received
    December 18, 2013
    Date of Event
    August 10, 2012
    Report Date
    August 20, 2012
    Manufacturer
    DEPUY SYNTHES POWER TOOLS
    Product Code
    HBC
    PMA / PMN Number
    K011444
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE HAS BEEN 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. WHEN THE INVESTIGATION HAS BEEN COMPLETED OR ADDITIONAL INFO BECOMES AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT. REF: (B)(4).

    Description of Event or Problem · 1

    REPORT 1 OF 2. REPORT RECEIVED FROM (B)(6) STATING THAT THE DEVICE HAD DEBRIS IN STERILE PACKAGE. THE DEVICE WAS NOT BEING USED DURING SURGERY. NO INJURY OR MEDICAL INTERVENTION OCCURRED. NO ADDITIONAL INFO PROVIDED. THE DATE OF THE EVENT WAS UNK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    663314 4MM FLUTED BALL HBC DEPUY SYNTHES POWER TOOLS F033059521

    Patients

    Seq Age Sex Outcome Treatment
    1