MITEK DOVETALL DRILL GUIDE 213816

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06,07 report with the FDA on 2007-10-01 for MITEK DOVETALL DRILL GUIDE 213816 manufactured by Depuy Mitek.

Event Text Entries

[18206366] We believe that this type of event is most likely technique related, extensive lab testing has shown that under normal conditions the reported event mode could not be duplicated, however, under extreme conditions, that is when the drill guide was bent during drilling with a drill bit, this caused the drill bit to rub against inner surface of the bent drill guide causing some metal to shave off of the drill guide, the reported condition was then duplicated. This phenomena has been the subject of a long and considerable study. At this point in time, the engineering design and the quality engineering teams are in the midst of developing some design changes to subvert and or greatly reduce this type of event. 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. When and if the complaint device is received here at mitek, it will be forwarded to the group to subsidize their study, and this file will remain receptive to any germane data generated by the group's study and forthcoming conclusions. At this point in time no further action is warranted.
Patient Sequence No: 1, Text Type: N, H10


[18228263] Our rep is reporting that during a shoulder repair some metal shavings went into the patient's body while using a mitek dovetall drill guide. It is not know if all of the debris was removed from the body. The case was concluded successfully without further incident or harm to the patient
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1221934-2007-00279
MDR Report Key920603
Report Source05,06,07
Date Received2007-10-01
Date of Report2007-09-13
Date Facility Aware2007-09-13
Report Date2007-09-13
Date Reported to Mfgr2007-09-13
Date Mfgr Received2007-09-13
Date Added to Maude2007-11-14
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 ContactMR. ARTHUR FRIGAULT
Manufacturer Street325 PARAMOUNT DRIVE
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal02767
Manufacturer Phone5089773856
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameMITEK DOVETALL DRILL GUIDE
Generic NameARTHROSCOPIC INSTRUMENT
Product CodeLXI
Date Received2007-10-01
Model Number213816
Catalog Number213816
Lot NumberUNK
ID NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrN
Implant FlagN
Date RemovedB
Device Sequence No1
Device Event Key909144
ManufacturerDEPUY MITEK
Manufacturer Address325 PARAMOUNT DRIVE


Patients

Patient NumberTreatmentOutcomeDate
10 2007-10-01

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