FDA Adverse Event Injury Summary report: N

GUIDEWIRE Ø1.25 W/THREAD-TIP W/TROCAR L1

MDR report key: 5740173 · Received June 21, 2016

Report

Report Number
2520274-2016-13242
Event Type
Injury
Date Received
June 21, 2016
Date of Event
June 5, 2016
Report Date
June 15, 2016
Manufacturer
SYNTHES USA
Product Code
LRN
PMA / PMN Number
PPREADM
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. 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

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. (B)(4). NOT IMPLANTED OR EXPLANTED. DEVICE IS EXPECTED TO BE RETURNED TO SYNTHES MANUFACTURER FOR EVALUATION /INVESTIGATION, BUT HAS YET TO BE RECEIVED. (B)(6). DEVICE HISTORY RECORDS WAS CONDUCTED. THE REPORT INDICATES THAT THE: LOT IS EITHER 9733073 OR 9894439. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. LOT 9733073 / UNSTERILE 9682651. MANUFACTURING SITE: (B)(4), SUPPLIER: (B)(4), MANUFACTURING DATE: 19. NOV. 2015, EXPIRY DATE: 01. NOV. 2025. PART WAS FIRST MANUFACTURED UNSTERILE IN BALSTHAL UNDER THE LOT 9682651, AS THE COMPLAINT IS NOT RELATED TO STERILISATION OR PACKAGING ONLY THE DOCUMENTS OF THE UNSTERILE LOT WERE REVIEWED: NO NCRS WERE GENERATED DURING PRODUCTION. REVIEW OF THE DEVICE HISTORY RECORD SHOWED THAT THERE WERE NO ISSUES DURING THE MANUFACTURE OF THE PRODUCT THAT WOULD CONTRIBUTE TO THIS COMPLAINT CONDITION. LOT 9894439 / UNSTERILE 9881137, MANUFACTURING SITE: (B)(4), SUPPLIER: (B)(4), MANUFACTURING DATE: 05. APRIL. 2016, EXPIRY DATE: 01. MAR. 2026. PART WAS FIRST MANUFACTURED UNSTERILE IN BALSTHAL UNDER THE LOT 9881137, AS THE COMPLAINT IS NOT RELATED TO STERILISATION OR PACKAGING ONLY THE DOCUMENTS OF THE UNSTERILE LOT WERE REVIEWED: NO NCRS WERE GENERATED DURING PRODUCTION. REVIEW OF THE DEVICE HISTORY RECORD SHOWED THAT THERE WERE NO ISSUES DURING THE MANUFACTURE OF THE PRODUCT THAT WOULD CONTRIBUTE TO THIS COMPLAINT CONDITION. 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

UPDATED CIA: TWO GUIDE WIRES, 1.25MM, WITH THREADED-TIP WITH TROCAR, LENGTH 150MM (PART NUMBER 292.620, LOT 9894439 & 9733073) WAS REPORTED AS BROKEN, BUT WAS NOT RETURNED FOR FURTHER EVALUATION. WITHOUT PRODUCT AN INVESTIGATION OR A ROOT CAUSE CANNOT BE PERFORMED/DEFINED. THE DHR REVIEW SHOWS THAT THE DEVICES MET THE SPECIFICATIONS AT THE TIME OF MANUFACTURING AND DISTRIBUTING. DEVICE USED FOR TREATMENT, NOT DIAGNOSIS. 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

UPDATE 24 JUNE 2016 - ADDITIONAL INFORMATION RECEIVED 15 JUNE 2016: THREE ARTICLES WERE AFFECTED IN TOTAL 2X GUIDE WIRE AND 1X DRILL BIT. THE BROKEN OFF PIECES WERE LEFT IN THE PATIENT. THIS REPORT IS 1 OF 3 FOR (B)(4).

Description of Event or Problem · 1

DEVICE REPORT FROM SYNTHES ON AN EVENT IN (B)(6) AS FOLLOWS: IT WAS REPORTED THAT A GUIDE WIRE BROKE DURING SURGERY. THE SURGEON WAS PREVIOUSLY UNHAPPY ABOUT THE DRILL BIT AND REPORTED IT AS BLUNT, HE WAS GIVEN ANOTHER DRILL BIT FROM ANOTHER SET, THESE ARE REUSED DRILL BITS. HE LATER REPORTED THAT THE GUIDE WIRE WAS BROKEN INSIDE THE PATIENT AND THIS WAS A DIRECT RESULT OF USING A BLUNT DRILL BIT. THIS COMPLAINT INVOLVES 1 PART. THIS REPORT IS 1 OF 1 FOR (B)(4).

Description of Event or Problem · 1

UPDATED 02.AUGUST 2016:

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
393821 GUIDEWIRE Ø1.25 W/THREAD-TIP W/TROCAR L1 WIRE,SURGICAL LRN SYNTHES USA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention