FDA Recall Terminated

Conical portio adapter (acorn) small & large are used for examination and diagnosis in conjunction with endoscopic accessories in gynecological laparoscopy, to determine patency of the fallopian tubes.

Recall: Z-2608-2016 · Initiated May 19, 2016

Recall

Recall Number
Z-2608-2016
Event Number
74656
Firm
Richard Wolf Medical Instruments Corp.
FEI Number
1418479
Product Code
HHI
Status
Terminated
Root Cause
Nonconforming Material/Component
Initiated
May 19, 2016
Terminated
November 30, 2017
Address
353 Corporate Woods Pkwy, Vernon Hills, IL, 60061-3110

Description

Conical portio adapter (acorn) small & large are used for examination and diagnosis in conjunction with endoscopic accessories in gynecological laparoscopy, to determine patency of the fallopian tubes.

Reason

The distal end of the Conical portio adapter (acorn) is composed of a small cap (head) that partially sits inside a hollow shaft (tube). These two parts are welded together to create one piece. In the impacted batches of product, the weld was improperly performed. As a result, the two pieces are not properly joined. This potential failure can result in the separation of the two pieces. The possible separation of these two components presents a potential risk to patients.

Action

Customers impacted were notified via Urgent Medical Device Recall Letter dated 5/31/2016 via certified mail. The letter describes the reason for the recall. Richard Wolf Identified the following measures to be taken by the consignees: 1. Immediately examine your inventory and quarantine product subject to recall. Richard Wolf Medical Instruments Corporation strongly recommends not using the potentially defective products. Please make sure that all users of the aforementioned products become aware of this urgent safety information. 2. If you have further distributed this product, please identify your customers and immediately notify them about this product recall. Your notification to your customers may be enhanced by including a copy of this recall notification letter, but must include instructions on what customers should do with the recalled product. 3. PLEASE COMPLETE ENCLOSED ANSWER FORM {even if the product is no longer in your inventory) and return the record to Richard Wolf Medical Instruments Corporation before June 17, 2016. Your return of the answer form will: " Confirm receipt of this safety information " Trigger a replacement order. Richard Wolf Medical Instruments Corporation will provide your facility with a return authorization number and shipping instructions and will bear the cost for shipping (returns to RWMIC and replacements to facility). 4. Please immediately inform Richard Wolf Medical Instruments Corporation of any adverse events. If the consignees have any questions they are asked to contact Lisa Williams, Regulatory Affairs Assistant at Richard Wolf Medical Instruments Corporation Richard Wolf Medical Instruments Corporation. Telephone: (847) 913-1113 Ext: 256 Telephone: (847) 913-1113 Ext: 225 Fax: (847) 913-0924 Fax: (847) 913-0924 Email : [email protected] Monday through Friday, 7:30AM to 4:00 PM CST. Monday through Friday, 9:00AM to 5:30 PM

Distribution

U.S. Consignees: AK, AL, AR, AZ, CA, CT, DC, FL, GA, IA, IL, KY, MA, MI, MN, MO, MS, NC, NE, NJ, NY, OH, OR, TX, UT and VA.

Quantity

Product code 8378.90- 94 pieces & Product code 8378.91 - 32 pieces