GOUGE 15MM-STRAIGHT 399.630

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-02-04 for GOUGE 15MM-STRAIGHT 399.630 manufactured by Oberdorf Synthes Produktions Gmbh.

Event Text Entries

[135196318] Complainant part is not expected to be returned for manufacturer review/investigation. Synthes sales representative. Without a lot number the device history records review could not be completed. The investigation could not be completed; no conclusion could be drawn, as no product was received. The investigation could not be completed; no conclusion could be drawn, as no product was received. 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.
Patient Sequence No: 1, Text Type: N, H10


[135196319] Device report from synthes reports an event in (b)(6) as follows: it was reported that on an unknown date, the handle of a gouge cancellous bone graft was broken. It is unknown how was the issue discovered. It was unknown if there was a procedure or patient involvement. This complaint involves one (1) device. This report is 1 of 1 for (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number8030965-2019-60615
MDR Report Key8302581
Date Received2019-02-04
Date of Report2019-01-16
Date Mfgr Received2019-03-08
Date Added to Maude2019-02-04
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 ContactKARA DITTY-BOVARD
Manufacturer StreetEIMATTSTRASSE 3
Manufacturer CityOBERDORF 4436
Manufacturer CountrySZ
Manufacturer Postal4436
Manufacturer Phone6103142063
Manufacturer G1WERK BETTLACH (CH)
Manufacturer StreetMURACHERSTRASSE 3
Manufacturer CityBETTLACH 2544
Manufacturer CountrySZ
Manufacturer Postal Code2544
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameGOUGE 15MM-STRAIGHT
Generic NameGOUGE,SURGICAL,GEN & PLASTIC SURGERY
Product CodeGDH
Date Received2019-02-04
Catalog Number399.630
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerOBERDORF SYNTHES PRODUKTIONS GMBH
Manufacturer AddressEIMATTSTRASSE 3 OBERDORF 4436 SZ 4436


Patients

Patient NumberTreatmentOutcomeDate
10 2019-02-04

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