FDA Adverse Event Malfunction Summary report: N

SMARTSTITCH PP CONNECTOR

MDR report key: 7249674 · Received February 7, 2018

Report

Report Number
3006524618-2018-00067
Event Type
Malfunction
Date Received
February 7, 2018
Date of Event
January 18, 2018
Report Date
March 6, 2018
Manufacturer
ARTHROCARE CORP.
Product Code
NBH
PMA / PMN Number
K123268
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE REPORTED PERFECTPASSER CONNECTOR, INTENDED FOR USE IN TREATMENT, WAS RETURNED FOR EVALUATION. A RELATIONSHIP BETWEEN THE DEVICE AND REPORTED INCIDENT WAS ESTABLISHED. FROM THE INFORMATION PROVIDED, THE DEVICE FAILED AND DISLODGED FROM THE TIP. VISUAL INSPECTION SHOWS THE CONNECTOR WAS RECEIVED WITH THE S-CLAMP UNHOOKED FROM THE S-HOOK AND THE S-CLAMP WAS NOT RETURNED. ALSO A SUTURE CARTRIDGE IS ATTACHED INTO THE DEVICE. INTERNAL INVESTIGATION INDICATES THE FAILURE CAUSE FOR UPPER S-CLAMP COMING LOOSE IS DUE TO A DIMENSIONAL DISCREPANCY ON THE S-HOOK COMPONENT. CHANGES TO THE COMPONENT HAVE BEEN IMPLEMENTED TO PREVENT THIS FAILURE. THERE WERE NO INDICATIONS THAT WOULD SUGGEST THAT THE DEVICE DID NOT MEET PRODUCT SPECIFICATIONS UPON RELEASE INTO DISTRIBUTION.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SELF CAPTURE DEVICE FAILED AND DISLODGED FROM THE TIP OF TWO DEVICES FROM THE LOT 2005153 AND DEVICE FROM LOT 1192014. THE BROKEN PIECES WERE REMOVED AND THE PROCEDURE WAS COMPLETED USING A BACK-UP DEVICE. NO PATIENT INJURY OR OTHER COMPLICATIONS WERE REPORTED. COMPLAINT 1 OF 3. SEE (B)(4) FOR RELATED COMPLAINTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
90878 SMARTSTITCH PP CONNECTOR ACCESSORIES,ARTHROSCOPIC NBH ARTHROCARE CORP. 2005153

Patients

Seq Age Sex Outcome Treatment
1