FDA Adverse Event Malfunction Summary report: N

QUICKSET TAPER HEX SCDR RIGID

MDR report key: 6784749 · Received August 10, 2017

Report

Report Number
1818910-2017-22575
Event Type
Malfunction
Date Received
August 10, 2017
Report Date
July 12, 2017
Manufacturer
DEPUY ORTHOPAEDICS, INC. 1818910 
Product Code
HXX
UDI-DI
10603295109235
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
ME, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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

EXAMINATION OF THE RETURNED INSTRUMENT CONFIRMED THE REPORTED OBSERVATION. 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. 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

IT WAS REPORTED THAT THE RIGID HOX SCREWDRIVER STRIPPED AND WILL NOT WORK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
566164 QUICKSET TAPER HEX SCDR RIGID HIP INSTRUMENT/TRIAL HXX DEPUY ORTHOPAEDICS, INC. 1818910  AG0185125 10603295109235

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention