FDA Adverse Event Malfunction Summary report: N

SFX TORQUE HANDLE

MDR report key: 9107681 · Received September 23, 2019

Report

Report Number
1526439-2019-52139
Event Type
Malfunction
Date Received
September 23, 2019
Report Date
August 29, 2019
Manufacturer
DEPUY SPINE INC
Product Code
LXH
UDI-DI
10705034224367
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT #(B)(4). INVESTIGATION SUMMARY ==> THE SFX TORQUE HANDLE [PRODUCT CODE: 2894-10-150, LOT NUMBER: GB77677 ] 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 BELOW THE LOWER SPECIFICATION LIMIT (LSL) OF (60.45-69.55 LBF.IN) RANGE 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 UNDER TORQUEING CANNOT BE POSITIVELY DETERMINED. ALTHOUGH NOT PROVEN, THE MOST PROBABLE ROOT CAUSE FOR THE UNDER TORQUEING OF THE HANDLE CAN BE ATTRIBUTED TO LACK OF MAINTENANCE DURING ITS TIME IN USE, RESULTING IN THE TORQUE HANDLE EXERTING LESS TORQUE THAN ITS LOWER SPECIFICATION LIMIT (LSL) OF (60.45-69.55 LBF.IN) RANGE SPECIFIED IN TM-100331 REV. 15. 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

(B)(4). THE DEVICE IS AVAILABLE FOR EVALUATION. INVESTIGATION WILL BE CONDUCTED. FOLLOW UP WILL BE FILED WITH THE INVESTIGATION RESULTS. 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

LIBERTAS: IT WAS REPORTED THAT ON (B)(6) 2019, THE UNIPLATE ANTERIOR CERVICAL PLATE SYSTEM CAM TIGHTENER TORQUE HANDLE HAS FAILED DURING THE CALIBRATION DURING REVERSE LOGISTICS AUDIT OF RETURNED DEVICE AT MILLSTONE. THERE WAS NO PATIENT INVOLVEMENT AND NO ADDITIONAL INFORMATION IS AVAILABLE. THIS COMPLAINT INVOLVES TEN (10) DEVICES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
897294 SFX TORQUE HANDLE ORTHOPEDIC MANUAL SURGICAL INSTRUMENT LXH DEPUY SPINE INC 289410150 GB77677 10705034224367

Patients

Seq Age Sex Outcome Treatment
1