CORDCUTTER *EA 214646

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2018-10-29 for CORDCUTTER *EA 214646 manufactured by Depuy Mitek Llc Us.

Event Text Entries

[125289663] If additional information should become available, a supplemental medwatch will be submitted accordingly. (b)(4). Investigation summary: the complaint device was received and inspected. The complaint cannot be confirmed. Visual observation revealed light nicks and marks at the distal tip, and when the cutter rod was removed some debris was present along the surface of the rod. When tested for its functionality, it was fully functional, but the device cutter could not be returned to the original position easily. It is possible that debris has built up inside the device after being reused multiple times and not cleaned properly. However, given the information provided we cannot discern a definitive root cause for the reported failure. A device history record (dhr) review has been conducted to determine if there were any internal processing issues which would have contributed to the nature of the product complaint. Our results indicate that this batch of product was processed without incident; therefore, there is no evidence of manufacturing anomalies on the paperwork reviewed. At this point, no corrective action is required and no further action is warranted. However, depuy synthes mitek will continue to track any related complaints within this device family as a means of monitoring the extent with which this complaint is observed in the field.
Patient Sequence No: 1, Text Type: N, H10


[125289664] It was reported by the sales rep that during a rotator cuff repair, a cord cutter broke during the procedure. The inner hub inserter piece became stuck and subsequently the handle could not be used. There was a 2 minute delay in the case and no patient consequences. A new cord cutter was opened and the case completed. Patient consequence? No. Is the information being submitted for this complaint all the details that are known/available regarding this event? Yes.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1221934-2018-55059
MDR Report Key8013772
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2018-10-29
Date of Report2018-06-21
Date of Event2018-06-20
Date Mfgr Received2018-06-21
Date Added to Maude2018-10-29
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMRS. JENNIFER LAWRENCE
Manufacturer Street325 PARAMOUNT DRIVE
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal02767
Manufacturer Phone5088808100
Manufacturer G1DEPUY MITEK LLC US
Manufacturer Street325 PARAMOUNT DRIVE
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal Code02767
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCORDCUTTER *EA
Generic NameSUTURE CUTTER
Product CodeFZT
Date Received2018-10-29
Returned To Mfg2018-07-17
Catalog Number214646
Lot Number15P09
Device AvailabilityR
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerDEPUY MITEK LLC US
Manufacturer Address325 PARAMOUNT DRIVE RAYNHAM MA 02767 US 02767


Patients

Patient NumberTreatmentOutcomeDate
10 2018-10-29

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