BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CRANIAL DRILL BITS AND ACCESSORIES

    MDR report key: 9707293 · Received February 13, 2020

    Report

    Report Number
    2183456-2019-00020
    Event Type
    Malfunction
    Date Received
    February 13, 2020
    Date of Event
    January 31, 2019
    Report Date
    February 13, 2020
    Manufacturer
    AD-TECH MEDICAL INSTRUMENT CORP.
    Product Code
    HBE
    UDI-DI
    00841823101167
    PMA / PMN Number
    K170442
    Removal / Correction Number
    2183456-08212019-R-004
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 1

    MDR 2183456-2019-00020 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-2183456-2019-00020 WAS SUBMITTED AS A CONSERVATIVE MEASURE DUE TO THE RECALLS TIED TO THIS ISSUE.

    Description of Event or Problem · 1

    ON (B)(6) 2019 AD-TECH RECEIVED A COMPLAINT FROM A USER FACILITY REGARDING THE FUSING OF AN AD-TECH DRILL BIT TO A ROSA GUIDE DURING A SEEG PROCEDURE. THE PROCEDURE COULD NOT PROCEED AND WAS SUBSEQUENTLY RESCHEDULED FOR THE FOLLOWING DAY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    168920 CRANIAL DRILL BITS AND ACCESSORIES CRANIAL DRILL BITS HBE AD-TECH MEDICAL INSTRUMENT CORP. DDK2-2.4-30X 208140673 00841823101167

    Patients

    Seq Age Sex Outcome Treatment
    1 Other