MAUDE MDR 1230136

MDR report key
1230136
Report number
9611610-2008-00001
Event key
0
Event type
3
Date received
2008-07-25
Adverse event
0
Product problem
0
Patients in event
0
Reporter occupation
0
Health professional
0
Initial report to FDA
0
Event location
0

Manufacturer Contact#

Address
DORFSTRASSE 2 DURCHHAUSEN 78591 GM
Phone
464-464-4641
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1***KBZ***NY

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12008-07-250

Event Narratives#

N

Patient 1

INVESTIGATION: AT THE DISTRIBUTOR'S REQUEST, SR SURGICAL INSTRUMENT ENGINEER, AND COMMERCIAL ASSISTANT, CHECKED THE INSTRUMENT THOROUGHLY, AND REVIEWED THE CO'S MFG RECORDS: THE INSTRUMENT IN QUESTION WAS MANUFACTURED IN NOVEMBER 2007 WITH LOT # 0711. 30 PCS. OUT OF THIS LOT WERE DELIVERED TO THE DISTRIBUTOR IN 2007. OUR ELECTRONICAL RECORDS ALLOW US TO TRACE BACK DELIVERY OF THIS ITEM TO JANUARY 2003. SINCE THEN, A LARGE QUANTITY OF THIS ARTICLE HAVE BEEN DELIVERED TO THE DISTRIBUTOR, AND WE HAVE NOT BEEN MADE AWARE OF ANY OTHER COMPLAINT OF THIS NATURE SO FAR. A THOROUGH REVIEW OF OUR PRODUCTION DOCUMENTS REVEALED NO NON-CONFORMANCES IN MATERIALS, MFG PROCESSES OR ANY DEVIATIONS WHATSOEVER WHEN COMPARING THE DEVICE(S) WITH THE MASTER SAMPLE AND/OR ENGINEERING DRAWING. THEY PASSED THE 100% QUALITY AND FUNCTIONAL CONTROL PRIOR TO DELIVERY. NO MATERIAL DEFECTS COULD BE DETECTED DURING VISUAL INSPECTION. THE INSTRUMENT WAS DISASSEMBLED INTO THE SINGLE COMPONENTS FOR INSPECTION, RE-ASSEMBLED AND TESTED, AND WE COULD NOT FIND ANY DEFECTS, MALFUNCTIONS OR WHATEVER. THE INSTRUMENT MEETS ALL SPECS, AND IS WORKING PROPERLY. WE CANNOT CONFIRM THE HOSP'S ASSUMPTION OF A BENT DISTAL CHANNEL. CONCLUSION: NO CONCLUSION AS TO THE EXACT CAUSE FOR THE INCIDENT DESCRIBED ABOVE CAN BE DRAWN. HOWEVER, A POSSIBLE REASON FOR THE MALFUNCTION DURING USE COULD BE THAT THE TONSIL WIRE HAD NOT BEEN INSERTED PROPERLY BEFORE USE OF THE INSTRUMENT. IF THIS HAD BEEN THE CASE, THE PULL ROD COULD GET JAMMED. BASED ON THE ABOVE INVESTIGATION, WE CONSIDER THIS TO BE AN UNJUSTIFIED COMPLAINT, BECAUSE THE INSTRUMENT MEETS ALL SPECS. NO DEFECT COULD BE FOUND AND A MISAPPLICATION/USER ERROR IS TO BE ASSUMED. CAPA ACTION REQUIRED? MFG PROCESS & DESIGN. NO. SINCE THERE IS NO INDICATION TO ASSUME A DEFECT IN MATERIAL, MFG NOR OUR TREND ANALYSIS REFLECTS ANY PROBLEMS WITH THIS PATTERN OR DESIGN, WE FEEL THAT NO CORRECTIVE OR PREVENTIVE ACTIONS ARE TO BE TAKEN AT OUR END. THE INSTRUMENT IN QUESTION HAS BEEN RETURNED TO THE DISTRIBUTOR.