FDA Adverse Event Malfunction Summary report: N

CRANIAL DRILL BIT AND ACCESSORIES

MDR report key: 9706095 · Received February 13, 2020

Report

Report Number
2183456-2019-00031
Event Type
Malfunction
Date Received
February 13, 2020
Date of Event
May 11, 2018
Report Date
February 13, 2020
Manufacturer
AD-TECH MEDICAL INSTRUMENT CORP.
Product Code
HBE
UDI-DI
00841823106520
Removal / Correction Number
2183456-08212019-R-004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

MDR 2183456-2019-00031 HAS BEEN FILED PAST THE 30-DAY TIMEFRAME. THROUGH THE 2019 FDA INSPECTION, IT WAS IDENTIFIED THAT WHILE AD-TECH WAS EVALUATING REPORTABILITY FOR ACTUAL EVENTS IN WHICH DEATH OR SERIOUS INJURY HAD OCCURRED, AD-TECH HAD FAILED TO SUBMIT EVENTS IN WHICH A MALFUNCTION WAS REPORTED AND COULD RESULT IN A SERIOUS INJURY IF THE EVENT WERE TO RECUR. AS PART OF THE INVESTIGATION, A TWO (2) YEAR RETROSPECTIVE REVIEW OF COMPLAINTS WAS PERFORMED TO DETERMINE WHICH COMPLAINTS REQUIRED SUBMISSION OF AN MDR. MDR-2183456-2019-00031 WAS SUBMITTED AS A CONSERVATIVE MEASURE DUE TO THE RECALLS TIED TO THIS ISSUE.

Description of Event or Problem · 1

A USER FACILITY REPORTED THAT THE DRILL BIT FUSED WITH THE DRILL SLEEVE GUIDE DESPITE LUBRICATION WITH MEDICAL GRADE MINERAL OIL. THERE WAS NO REPORT OF PATIENT HARM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
172407 CRANIAL DRILL BIT AND ACCESSORIES DRILL SLEEVE GUIDE HBE AD-TECH MEDICAL INSTRUMENT CORP. DSG-6.3-090-2.4N 812050 00841823106520

Patients

Seq Age Sex Outcome Treatment
1 Other