FDA Adverse Event Malfunction Summary report: N

PFC*CALIBRATED PAT CUT GDE

MDR report key: 5278197 · Received December 9, 2015

Report

Report Number
1818910-2015-37089
Event Type
Malfunction
Date Received
December 9, 2015
Date of Event
December 8, 2015
Report Date
December 8, 2015
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
LXH
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE ASSOCIATED WITH THE REPORTED EVENT WAS NOT RETURNED. A SEARCH OF THE COMPLAINT DATABASE FOUND ADDITIONAL REPORTS OF SAW CAPTURE BREAKAGE AGAINST PRODUCT CODE 865034. THE PREVIOUS REPORTS WERE INVESTIGATED AND THE ROOT CAUSES ATTRIBUTED TO PRODUCT WEAR OUT THROUGH NORMAL USE AND SERVICING. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS ABOUT THE CURRENT REPORTED EVENT WITHOUT THE INSTRUMENT TO EXAMINE. BASED ON THE INABILITY TO DETERMINE A ROOT CAUSE, A NEED FOR CORRECTIVE ACTION IS NOT INDICATED DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION WILL BE RE-OPENED AS NECESSARY.

Additional Manufacturer Narrative · 1

(B)(4). THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

THE PATELLA CUTTING GUIDE CAPTURE BROKE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
810611 PFC*CALIBRATED PAT CUT GDE KNEE INSTRUMENT/TRIAL LXH DEPUY ORTHOPAEDICS, INC. UNK

Patients

Seq Age Sex Outcome Treatment
1 72 YR