MENISCAL DEPLOYMENT GUN 228143

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,other report with the FDA on 2019-02-19 for MENISCAL DEPLOYMENT GUN 228143 manufactured by Depuy Mitek Llc Us.

Event Text Entries

[136607007] Product complaint # (b)(4). If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate. Investigation summary: the complaint omnispan applier was received and evaluated. The inspection of the applier revealed that the deployment rod was jammed in the needle, causing the gray trigger to be inoperable. After removing the needle from the applier it was found that the deployment rod (gray trigger) and loading rod (red trigger) were in the opposite positions of the correct configuration (loading rod on top, deployment rod on bottom). The applier was assembled incorrectly, with the loading rod being placed on bottom and the deployment rod on top. Because of the incorrect assembly of the device, when the surgeon attempted to deploy the first implant, the deployment rod deployed both the first and second implants simultaneously. To confirm this a meniscus simulator was used to test the applier with a new needle. Depressing the gray trigger deployed both the first and second implants with a single trigger pull. The failure of the applier can be attributed to incorrect assembly of the device. No lot numbers were supplied which precludes conducting a device history record review or a lot specific search in the complaints handling system. The omnispan applier is being returned to the supplier for further investigation. A nonconformance was opened to investigate this failure (nc # (b)(4)). At this point in time, no immediate 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. This report is being filed from the (b)(4) as required under mitek's corrective and preventative actions (capa) to file usa fda mdr missed malfunctions. (b)(4). The lot number is unknown.
Patient Sequence No: 1, Text Type: N, H10


[136607008] It was reported by the affiliate that at the time of surgery using ominispan meniscal repair 0? , the applicator did not fire the second stitch. To solve the problem was necessary to open new suture, when changing the load, same problem occurred, continued not firing the second point. Considering that the doctor which has enough experience with handling the product requested authorization to send the product for analysis. There was no harm to the patient and the surgery did not exceed time longer than 30 minutes. Images below. Additional information received via email from the affiliate on 2-27-2017 the first implant was left implanted, no problem related to the first fire. It was necessary to open a new suture to complete the procedure. Additional information received via email from the affiliate on 3-22-2017 reporting same location was used to complete the procedure. It was also reported that the device and needles will be returned for evaluation.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1221934-2019-56437
MDR Report Key8352174
Report SourceFOREIGN,OTHER
Date Received2019-02-19
Date of Report2017-02-03
Date of Event2017-01-25
Date Mfgr Received2017-02-03
Date Added to Maude2019-02-19
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 Street325 PARAMOUNT DRIVE
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal02767
Manufacturer Phone6103142063
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 NameMENISCAL DEPLOYMENT GUN
Generic NameORTHOPAEDIC CERCLAGE APPLIER
Product CodeGEF
Date Received2019-02-19
Returned To Mfg2017-03-30
Catalog Number228143
Lot NumberUNKNOWN
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerDEPUY MITEK LLC US
Manufacturer Address325 PARAMOUNT DRIVE RAYNHAM MA 02767 US 02767


Patients

Patient NumberTreatmentOutcomeDate
10 2019-02-19

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