SUMMIT CALCAR PLANER-LARGE 257004200

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 2019-12-23 for SUMMIT CALCAR PLANER-LARGE 257004200 manufactured by Depuy Orthopaedics Inc Us.

Event Text Entries

[184388781] Product complaint # (b)(4). Investigation summary ==> examination of the returned instrument found the planer is dull. The root cause is attributed to heavy usage/ wear out. Depuy considers the investigation closed at this time. Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary. 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


[188321242] 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: examination of the returned instrument found the planer is dull. The root cause is attributed to heavy usage/ wear out. Depuy considers the investigation closed at this time. Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary.
Patient Sequence No: 1, Text Type: N, H10


[188321263] It was reported that calcar planers need to be replaced. No surgical delay.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1818910-2019-124526
MDR Report Key9510402
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2019-12-23
Date of Report2019-10-28
Date of Event2019-10-28
Date Mfgr Received2019-12-17
Device Manufacturer Date2008-08-15
Date Added to Maude2019-12-23
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 ContactKARA DITTY-BOVARD
Manufacturer Street1210 WARD AVENUE
Manufacturer CityWEST CHESTER PA 193800988
Manufacturer CountryUS
Manufacturer Postal193800988
Manufacturer Phone6103142063
Manufacturer G1DEPUY ORTHOPAEDICS, INC. 1818910
Manufacturer Street700 ORTHOPAEDIC DR.
Manufacturer CityWARSAW IN 465810988
Manufacturer CountryUS
Manufacturer Postal Code465810988
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSUMMIT CALCAR PLANER-LARGE
Generic NameHIP INSTRUMENTS : REAMERS
Product CodeLYS
Date Received2019-12-23
Returned To Mfg2019-11-13
Catalog Number257004200
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerDEPUY ORTHOPAEDICS INC US
Manufacturer Address700 ORTHOPAEDIC DRIVE WARSAW IN 465810988 US 465810988


Patients

Patient NumberTreatmentOutcomeDate
10 2019-12-23

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