FDA Adverse Event Malfunction Summary report: N

3MM COARSE DIAMOND BALL

MDR report key: 3981621 · Received December 18, 2013

Report

Report Number
1045834-2013-16223
Event Type
Malfunction
Date Received
December 18, 2013
Report Date
June 22, 2012
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
HSZ
PMA / PMN Number
K981465
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 1 OF 2. REPORT RECEIVED FROM (B)(6) STATING THAT THE DEVICE WAS RETURNED DUE TO "RETURNED PRODUCT UNUSED - INCOMING ORDER FAILED DISTRIBUTOR'S INSPECTIONS." THE DEVICE WAS NOT BEING USED DURING SURGERY AND NO INJURY OR MEDICAL INTERVENTION OCCURRED. THE DATE OF THE EVENT IS UNK. THERE WAS NO ADD'L INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
663289 3MM COARSE DIAMOND BALL HSZ DEPUY SYNTHES POWER TOOLS E433057395

Patients

Seq Age Sex Outcome Treatment
1