FDA Adverse Event Malfunction Summary report: N

BIOMET MICROFIXATION FACIAL PLATING SYSTEM

MDR report key: 6417747 · Received March 20, 2017

Report

Report Number
0001032347-2017-00210
Event Type
Malfunction
Date Received
March 20, 2017
Date of Event
February 17, 2017
Report Date
December 11, 2018
Manufacturer
BIOMET MICROFIXATION
Product Code
HRS
PMA / PMN Number
K142823
Removal / Correction Number
N/A
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT WAS SUBMITTED TO CORRECT THE DEVICE PRODUCT CODE AND 510(K) NUMBER. THE FOLLOWING SECTIONS WERE CORRECTED: DEVICE PRODUCT CODE: JEY, CORRECTED TO HRS; G5 PMA/510(K) NUMBER: K121589, CORRECTED TO K142823. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 0001032347-2017-00200-2.

Additional Manufacturer Narrative · 1

DRIVER LOT # 801390 HAD A VERY ROUGH ROTATION WHEN OPERATED INDICATING EXCESS FRICTION BETWEEN THE MESHING GEARS. THE DRIVER HEAD WAS REMOVED TO INSPECT THE GEARS AND THERE WAS A LARGE AMOUNT OF FOREIGN MATERIAL ON THE DRIVE SHAFT GEAR FACE THAT WAS CAUSING THE GEARS NOT TO MESH CORRECTLY. THE DRIVER WAS FUNCTIONALLY TESTED AND CONFIRMED TO NOT TRANSMIT ANY TORQUE TO THE BLADE. FURTHER INSPECTION REVEALED THE MAIN GEAR ON THE DRIVE SHAFT HAD SHEARED THE DOWEL PIN THAT LOCKED IT IN PLACE AND IT WAS ABLE TO SPIN FREELY ON THE DRIVE SHAFT. THE MOST LIKELY CAUSE OF THIS IS EXCESSIVE TORQUE. THERE ARE NO SIGNS OF MANUFACTURING DEFECTS. SUPPLEMENTAL REPORT TWO OF TWO FOR THE SAME EVENT, REFERENCE REPORT 0001032347-2017-00200-1.

Additional Manufacturer Narrative · 1

REVIEW OF DEVICE HISTORY RECORDS SHOW THE LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A VALID CONCLUSION ABOUT THE CAUSE OF THIS EVENT; A FOLLOW-UP REPORT WILL BE SENT UPON COMPLETION OF THE DEVICE EVALUATION. REPORT TWO OF TWO FOR THE SAME EVENT, REFERENCE REPORT 0001032347-2017-00200.

Description of Event or Problem · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY CORRECTED AND ADDITIONAL INFORMATION.

Description of Event or Problem · 1

IT WAS REPORTED THE INTERNAL GEAR IN TWO DRIVERS BROKE DURING A RIB FRACTURE CASE. A BACK UP DRIVER WAS USED TO COMPLETE THE SURGERY; THERE WAS NO DELAY OR INJURY TO THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
201281 BIOMET MICROFIXATION FACIAL PLATING SYSTEM 90 DEGREE CONTRA ANGLE SCREWDRIVER HRS BIOMET MICROFIXATION N/A 801390

Patients

Seq Age Sex Outcome Treatment
1