FDA Adverse Event Malfunction Summary report: N

1.8MM FLUTED MATCHSTICK

MDR report key: 3984067 · Received December 18, 2013

Report

Report Number
1045834-2013-16313
Event Type
Malfunction
Date Received
December 18, 2013
Report Date
June 22, 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 INFORMATION BECOMES AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4).

Description of Event or Problem · 1

REPORT RECEIVED FROM (B)(6) STATING THAT THE DEVICE WAS RETURNED UNUSED BECAUSE IT "FAILED DISTRIBUTOR'S INSPECTIONS." DEBRIS IN STERILE PACKAGING WAS OBSERVED. THE DEVICE WAS NOT BEING USED DURING SURGERY AND NO INJURY OR MEDICAL INTERVENTION OCCURRED. THE DATE OF EVENT IS UNKNOWN. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
663076 1.8MM FLUTED MATCHSTICK GFF DEPUY SYNTHES POWER TOOLS E513059903

Patients

Seq Age Sex Outcome Treatment
1