FDA Adverse Event Malfunction Summary report: N

LOCKING DRILL GUIDE WITH TISSUE PROTECTION SLEEVE

MDR report key: 7255691 · Received February 8, 2018

Report

Report Number
2939274-2018-50566
Event Type
Malfunction
Date Received
February 8, 2018
Report Date
January 17, 2018
Manufacturer
WRIGHTS LANE: SYNTHES USA PRODUCTS LLC
Product Code
FZX
UDI-DI
10705034769158
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

DEPUY SYNTHES IS SUBMITTING THIS REPORT PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH DEPUY SYNTHES HAS NOT BEEN ABLE TO INVESTIGATE OR VERIFY PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY FDA, DEPUY SYNTHES OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE DEVICE, DEPUY SYNTHES, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. ADDITIONAL NARRATIVE: DEVICE HISTORY RECORD (DHR) REVIEW: PART # 324.061; SYNTHES LOT # 4220573; SUPPLIER LOT # NA; RELEASE TO WAREHOUSE DATE: 08MAR2001; MANUFACTURED BY SYNTHES BRANDYWINE; NO NONCONFORMANCE RECORDS (NCRS) WERE GENERATED DURING PRODUCTION. REVIEW OF THE DEVICE HISTORY RECORD(S) SHOWED THAT THERE WERE NO ISSUES DURING THE MANUFACTURE OF THIS PRODUCT, AND ANY SUB-COMPONENTS, WHICH WOULD CONTRIBUTE TO THIS COMPLAINT CONDITION. SERVICE & REPAIR EVALUATION: THE CUSTOMER REPORTED THE INSTRUMENT WAS BROKEN IN TWO PIECES. THE REPAIR TECHNICIAN REPORTED THE SCREW WAS MISSING AND THE SCREW HOLE WAS DAMAGED. MISSING PARTS IS THE REASON FOR REPAIR. THE ITEM IS NOT REPAIRABLE PER THE INSPECTION SHEET. THE CAUSE OF THE ISSUE IS UNKNOWN. THE ITEM WILL BE FORWARDED TO CUSTOMER QUALITY. THE EVALUATION WAS CONFIRMED. THE FOLLOWING INVESTIGATION FLOW WAS PERFORMED: VISUAL (APPEARANCE NOT AS EXPECTED). VISUAL INSPECTION PERFORMED AT CUSTOMER QUALITY (CQ) CONFIRMED THE CONDITION OF A MISSING SCREW COMPONENT AND DAMAGED HOLE. THE RETURNED DEVICE WAS RETURNED IN TWO PIECES, BUT HAS FALLEN APART DUE TO A MISSING SCREW. THERE IS NO EVIDENCE OF ANY BREAKAGE ON THE DEVICE. THIS DOES NOT AGREE WITH REPORTED CONDITION OF DEVICE BREAKAGE. THE SCREW COMPONENT THAT HOLDS THE FORGED HANDLES TOGETHER IS MISSING AND WAS NOT RETURNED. THE HOLE THAT IS MISSING THE SCREW DOES SHOW POST MANUFACTURING DAMAGE. THE RETURNED DEVICE WAS MANUFACTURED IN MARCH 2001 AND IS OVER 17 YEARS OLD. NO NCR'S WERE GENERATED DURING PRODUCTION. REVIEW OF THE DEVICE HISTORY RECORD(S) SHOWED THAT THERE WERE NO ISSUES DURING THE MANUFACTURE OF THIS PRODUCT, AND ANY SUB-COMPONENTS, WHICH WOULD CONTRIBUTE TO THIS COMPLAINT CONDITION. DRILL GUIDE ASSEMBLY DRAWINGS WERE REVIEWED DURING THIS INVESTIGATION. NO PRODUCT DESIGN ISSUES OR DISCREPANCIES WERE OBSERVED. A DIMENSIONAL INSPECTION OF FEATURES RELEVANT TO THIS COMPLAINT COULD NOT BE OBTAINED AT CQ BECAUSE THE SCREW WAS NOT RETURNED AND THE HOLE IS DAMAGED. THIS COMPLAINT IS CONFIRMED HOWEVER NO PRODUCT DESIGN ISSUES OR MANUFACTURING DISCREPANCIES THAT WOULD CONTRIBUTE TO THE REPORTED COMPLAINT CONDITION WERE IDENTIFIED DURING THIS INVESTIGATION. THE MOST LIKELY CAUSE FOR THE COMPLAINT CONDITION IS ROUGH HANDLING AND CUMULATIVE WEAR FOR OVER 17 YEARS OF USE. BASED ON THE INVESTIGATION FINDINGS, IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND/OR PREVENTATIVE ACTION IS PROPOSED. 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 · 0

DEPUY SYNTHES IS SUBMITTING THIS REPORT PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH DEPUY SYNTHES HAS NOT BEEN ABLE TO INVESTIGATE OR VERIFY PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY FDA, DEPUY SYNTHES OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE DEVICE, DEPUY SYNTHES, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. DATE OF REPORT /DATE REC¿D BY MFR : INITIALLY REPORTED AS JANUARY 18, 2018, BUT SHOULD HAVE BEEN JANUARY 17, 2018. 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

NO PATIENT INVOLVEMENT. IT IS UNKNOWN WHEN THE EVENT OCCURRED. THIS REPORT IS FOR A DRILL GUIDE - UNKNOWN LOT. DEVICE IS AN INSTRUMENT AND IS NOT IMPLANTED/EXPLANTED. COMPLAINANT PART HAS NOT BEEN RETURNED FOR MANUFACTURER REVIEW/INVESTIGATION. WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. 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

FOLLOW-UP 1.

Description of Event or Problem · 1

(B)(6) REPORTED THAT AN INSTRUMENT WAS FOUND BROKEN IN 2 PIECES IN THE STERILE PROCESSING DEPT. IT IS NOT KNOWN WHEN AND HOW IT HAPPENED. THERE IS NO REPORTED PATIENT INVOLVEMENT.. THERE IS ONE DEVICE ON THIS COMPLAINT.

Description of Event or Problem · 1

(B)(6) REPORTED THAT AN INSTRUMENT WAS FOUND BROKEN INTO TWO (2) PIECES IN THE STERILE PROCESSING DEPARTMENT. IT IS NOT KNOWN WHEN AND HOW IT HAPPENED. THERE IS NO REPORTED PATIENT INVOLVEMENT. THIS IS REPORT 1 OF 1 FOR (B)(4). THIS REPORT IS FOR A DRILL GUIDE. THIS COMPLAINT INVOLVES ONE (1) DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
96562 LOCKING DRILL GUIDE WITH TISSUE PROTECTION SLEEVE GUIDE FZX WRIGHTS LANE: SYNTHES USA PRODUCTS LLC 4220573 10705034769158

Patients

Seq Age Sex Outcome Treatment
1