MAUDE MDR 5315362

MDR report key
5315362
Report number
9680938-2015-10130
Event key
0
Event type
3
Date received
2015-12-21
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
LINDA PLEWS
Address
1302 WRIGHTS LANE EAST WEST CHESTER PA 19380 US
Phone
610-610-6107
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BENDING PLIERS FOR 3.5MM CLAVICLE PLATES/227MM LENGTHINSTR, BENDING OR CONTOURINGSYNTHES TUTTLINGENHXP329.291T943130Y R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12015-12-210

Event Narratives#

N

Patient 1

ADDITIONAL NARRATIVE: EVENT DATE: UNKNOWN. DEVICE IS AN INSTRUMENT AND IS NOT IMPLANTED/EXPLANTED. THE DEVICE WAS RECEIVED, THE INVESTIGATION COULD NOT BE COMPLETED, AND NO CONCLUSION COULD BE DRAWN, AS PRODUCT IS ENTERING THE COMPLAINT SYSTEM. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

D

Patient 1

IT WAS REPORTED THAT DURING A ROUTINE FIELD EQUIPMENT INSPECTION OF A MODULAR CLAVICLE SET, IT WAS DISCOVERED THAT THE SCREW WAS MISSING ON THE BOTTOM OF THE PLIERS. THERE WAS NO PROCEDURE OR PATIENT INVOLVEMENT. THIS IS REPORT 1 OF 1 FOR (B)(4).

N

Patient 1

DEVICE HISTORY RECORDS WAS CONDUCTED. THE REPORT INDICATES THAT THE: MANUFACTURING DATE: JAN 29TH, 2010 PART#: 329.291, LOT#: T943130, REVIEW OF THE DEVICE HISTORY RECORDS SHOWED THAT THERE WERE NO ISSUES AT THE TIME OF MANUFACTURING OF THIS DEVICE THAT WOULD CONTRIBUTE TO THE ISSUE OUTLINED IN THIS COMPLAINT.THE PHOTO AND THE COMPLAINT DESCRIPTION SHOW THAT THE SCREW IS MISSING BUT THE THREADS WERE CHECKED AT THE FINAL INSPECTION OF THE DEVICE ON 29TH JANUARY 2010 AND FOUND TO BE CONFORMING. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

N

Patient 1

PRODUCT INVESTIGATION SUMMARY: THE COMPLAINT CONDITION FOR THE BENDING PLIERS (PART 329.291 / LOT T943130) WAS LIKELY CAUSED BY THE TIGHTENING SCREW BEING LOST UPON DISASSEMBLY IN STERILE PROCESSING; HOWEVER, THIS COMPLAINT IS NOT LIKELY A RESULT OF ANY DESIGN RELATED DEFICIENCY. THE BENDING PLIERS ARE AN INSTRUMENT ROUTINELY USED IN THE 3.5MM LCP SUPERIOR ANTERIOR CLAVICLE PLATES SYSTEM. THE DEVICE WAS RETURNED AND REPORTED TO HAVE BEEN FOUND WITHOUT THE SCREW IN THE BOTTOM HANDLE OF THE PLIERS. THIS CONDITION IS CONFIRMED AS THE TIGHTENING SCREW WAS NOT RETURNED WITH THE DEVICE. IT IS LIKELY THAT THE SCREW WAS LOST UPON DISASSEMBLY DURING STERILE PROCESSING LEADING TO THIS COMPLAINT CONDITION. THE DEVICE WAS MANUFACTURED IN JANUARY, 2010 AND IS SIX (6) YEARS OLD. THE BALANCE OF THE RETURNED DEVICE IS IN FAIR WORKING CONDITION CONSISTENT WITH SIX (6) YEARS OF USE. THE ASSOCIATED DRAWING NUMBER WAS REVIEWED AND DETERMINED TO BE SUITABLE FOR THE INTENDED DESIGN, APPLICATION, AND DIMENSIONAL CONFORMITY WHEN USED AS RECOMMENDED. THE CONDITION OF THE RETURNED DEVICE DOES AGREE WITH THE COMPLAINT DESCRIPTION. WHETHER THE COMPLAINT CONDITION FOR THIS DEVICE CAN BE REPLICATED IS NOT APPLICABLE FOR THIS CONDITION. NO NON-CONFORMANCE REPORTS WERE GENERATED DURING THE PRODUCTION OF THIS DEVICE. THE COMPLAINANT PART WAS ACTUALLY RECEIVED BY THE MANUFACTURER FOR EVALUATION ON DECEMBER 18, 2015. FIELD UPDATED WITH NEW DATE OF RECEIPT. DEVICE USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.