SAFETY SCALPEL D4511A

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-10-11 for SAFETY SCALPEL D4511A manufactured by S & S Surgical.

Event Text Entries

[123950783] Root cause: a definitive root cause has not been determined. However, the following possible root causes have been identified: the outside processor did not ensure the scalpel was locked in place before packaging into the poly bag or the scalpel was exposed to force during shipping that caused the handle to unlock and the blade to become exposed. Corrective action: packaging and labeling personnel were notified of the reported issue. Investigation summary: an internal report (call (b)(4)) was received indicating a safety scalpel (part d4511a) contained a blade that was loose and not secure inside the scalpel. The customer returned five cases (500 eaches) for evaluation. All five cases were opened and inspected. Of the 500 eaches, one blade was seen protruding from a scalpel handle. The locking mechanism of this scalpel as well as 19 others were checked, and all were found to be functioning correctly. Additionally, all five cases were seen to have a sticker on the box stating they were "released. " a review of the device history record showed no discrepancies related to the reported issue. Raw material and finished good inventory found no inventory with loose or exposed blades. The scalpels are supplied to deroyal be s & s surgical. The complaint investigator did not notify the supplier of the reported issue because the investigator determined the exposed blade was not a malfunction or defect of the scalpel. The locking mechanisms of the raw material scalpels were checked and all were found to be functioning correctly. An outside operation packages the scalpels into poly bags, closes the bags with twist ties, and places these bags into individual boxes to be shipped to deroyal. This outside operation was notified of the reported issue as well as personnel at deroyal's manufacturing facility where inspection is performed. Deroyal has sold (b)(4) cases or (b)(4) eaches of the finished good from september 2016 to present. During this same period, a total of six complaints (including this one) were received for this product. This equates to a complaint-to-sales ratio of (b)(4) percent. Deroyal will continue to monitor post-market feedback and will recognize in the future if a trend develops. The investigation is complete at this time. If new and critical information becomes available, this report will be updated.
Patient Sequence No: 1, Text Type: N, H10


[123950784] The blade was loose, not secured inside the scalpel.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2320762-2018-00006
MDR Report Key7957473
Date Received2018-10-11
Date of Report2018-10-11
Date of Event2018-09-11
Date Mfgr Received2018-09-12
Date Added to Maude2018-10-11
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 ContactSARAH BENNETT
Manufacturer Street200 DEBUSK LANE
Manufacturer CityPOWELL TN 37849
Manufacturer CountryUS
Manufacturer Postal37849
Manufacturer Phone8653626112
Manufacturer G1DEROYAL INDUSTRIES, INC.
Manufacturer Street1595 HIGHWAY 33 SOUTH
Manufacturer CityNEW TAZEWELL TN 37825
Manufacturer CountryUS
Manufacturer Postal Code37825
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameSAFETY SCALPEL
Generic NameHANDLE, SCALPEL
Product CodeGDZ
Date Received2018-10-11
Returned To Mfg2018-10-04
Model NumberD4511A
Lot Number47535838
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerS & S SURGICAL
Manufacturer Address117 EDGINGTON LANE WHEELING WV 26003 US 26003


Patients

Patient NumberTreatmentOutcomeDate
10 2018-10-11

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