TREPHINE SHAFT 242224000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-06-16 for TREPHINE SHAFT 242224000 manufactured by Depuy Orthopaedics, Inc..

Event Text Entries

[77841569] (b)(4). If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate. This complaint is still under investigation. Depuy will notify the fda of the results of this investigation once it has been completed.
Patient Sequence No: 1, Text Type: N, H10


[77841570] It was reported that while using depuy trephines, the part that attaches into the drill attachment broke off.
Patient Sequence No: 1, Text Type: D, B5


[104058080] Examination of the submitted device confirmed the reported breakage. Depuy considers the investigation closed. Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1818910-2017-19689
MDR Report Key6647663
Date Received2017-06-16
Date of Report2017-05-18
Date of Event2017-05-18
Date Mfgr Received2017-07-17
Device Manufacturer Date2013-05-31
Date Added to Maude2017-06-16
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactCHAD GIBSON
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 46581
Manufacturer CountryUS
Manufacturer Postal46581
Manufacturer Phone5743725905
Manufacturer G1DEPUY ORTHOPAEDICS, INC.
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal Code46582
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameTREPHINE SHAFT
Generic NameGENERAL/MISC INSTRUMENT
Product CodeHWK
Date Received2017-06-16
Returned To Mfg2017-06-01
Catalog Number242224000
Lot NumberVZ12337
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerDEPUY ORTHOPAEDICS, INC.
Manufacturer Address700 ORTHOPAEDIC DRIVE WARSAW IN 46582 US 46582


Patients

Patient NumberTreatmentOutcomeDate
10 2017-06-16

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