FDA Adverse Event Malfunction Summary report: N

SFX TORQUE HANDLE

MDR report key: 9078447 · Received September 17, 2019

Report

Report Number
1526439-2019-52092
Event Type
Malfunction
Date Received
September 17, 2019
Report Date
August 27, 2019
Manufacturer
DEPUY SPINE INC
Product Code
LXH
UDI-DI
10705034224367
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT # (B)(4). INVESTIGATION SUMMARY ==> THE SFX TORQUE HANDLE [PRODUCT CODE: 2894-10-150, LOT NUMBER: GB66895] WAS NOT RETURNED TO THE COMPLAINT HANDLING UNIT (CHU). INSTEAD, THE SAMPLE WAS RETURNED TO 5 STAR FOR REWORK AND RECALIBRATION. FIVE STAR SURGICAL, INC HAS PERFORMED THE TORSIONAL TEST FOR THE TORQUE HANDLE AND PROVIDED THE RESULTS TO THE COMPLAINTS HANDLING UNIT. TORQUE WRENCH WAS TESTED FOR RANGE (60.45-69.55 LBF.IN) ON A TORQUE METER (GAGE ID#: 78862). 18 READINGS WERE RECORDED AT MOUNTZ AND TELEDYNE TORQUE SERVICE LIMIT RANGE. IT WAS NOTED THAT THE HANDLE WAS TORQUEING ABOVE THE UPPER SPECIFICATION LIMIT (USL) OF (60.45-69.55 LBF.IN) RANGE SPECIFIED A REVIEW OF THE RECEIVING INSPECTION (RI) FOR SFX TORQUE HANDLE WAS CONDUCTED. AS A RESULT, THE RI IDENTIFIED NO ISSUES DURING THE MANUFACTURING AND RELEASE OF THIS DEVICE THAT COULD HAVE CONTRIBUTED TO THE PROBLEM REPORTED BY THE CUSTOMER. ALL COMPLAINT TRENDS WILL BE EVALUATED AS A PART OF THE DEPUY SPINE MONTHLY COMPLAINT REVIEW MEETING. A DEFINITIVE ROOT CAUSE FOR THE SFX TORQUE HANDLE OVER TORQUEING CANNOT BE POSITIVELY DETERMINED. ALTHOUGH NOT PROVEN, THE MOST PROBABLE ROOT CAUSE FOR THE OVER TORQUEING OF THE HANDLE CAN BE ATTRIBUTED TO LACK OF MAINTENANCE DURING ITS TIME IN USE, RESULTING IN THE TORQUE HANDLE EXERTING MORE TORQUE THAN ITS UPPER SPECIFICATION LIMIT (USL) OF (60.45-69.55 LBF.IN) RANGE NO CORRECTIVE ACTION/PREVENTIVE ACTION (CAPA) IS NECESSARY NOW AS NO ISSUES WERE IDENTIFIED IN THE MANUFACTURING AND RELEASE OF THIS DEVICE THAT COULD HAVE CONTRIBUTED TO THE PROBLEM REPORTED BY THE CUSTOMER. THEREFORE, THIS COMPLAINT FILE WILL BE CLOSED WITH NO FURTHER ACTION REQUIRED. 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

IF THE INFORMATION IS UNKNOWN, NOT AVAILABLE OR DOES NOT APPLY, THE SECTION/FIELD OF THE FORM IS LEFT BLANK. (B)(4). COMPLAINANT PART IS EXPECTED TO BE RETURNED FOR MANUFACTURER REVIEW/INVESTIGATION, BUT HAS YET TO BE RECEIVED. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. BASED ON THE INFORMATION AVAILABLE, IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND/OR PREVENTATIVE ACTION IS PROPOSED. THIS COMPLAINT WILL BE ACCOUNTED FOR AND MONITORED VIA POST MARKET SURVEILLANCE ACTIVITIES. IF ADDITIONAL INFORMATION IS MADE AVAILABLE, THE INVESTIGATION WILL BE UPDATED AS APPLICABLE. 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.

Description of Event or Problem · 1

IT WAS REPORTED THAT ON (B)(6) 2019, THE TORQUE CALIBRATION FAILURE DURING REVERSE LOGISTICS AUDIT OF RETURNED DEVICE AT MILLSTONE. THERE WAS NO PATIENT INVOLVEMENT AND NO ADDITIONAL INFORMATION IS AVAILABLE. THIS REPORT IS FOR A TORQUE DRIVER. THIS IS REPORT 2 OF 10 FOR (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
869307 SFX TORQUE HANDLE ORTHOPEDIC MANUAL SURGICAL INSTRUMENT LXH DEPUY SPINE INC 289410150 GB66895 10705034224367

Patients

Seq Age Sex Outcome Treatment
1