SIG FEM ADPT TORQUE WRENCH 96-1673 961673

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 2020-01-03 for SIG FEM ADPT TORQUE WRENCH 96-1673 961673 manufactured by Depuy Orthopaedics Inc Us.

Event Text Entries

[176517768] Product complaint #: (b)(4). Investigation summary: examination of the returned device revealed the plastic protector component is missing. The device was manufactured prior to a product enhancement and the investigation did not indicate that a broader investigation or corrective action was necessary. Depuy synthes considers the investigation closed at this time. Should additional information be received, the information will be reviewed and the investigation may be re-opened as necessary. If information is obtained that was not available for the initial medwatch, a follow-up medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[188741381] 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.
Patient Sequence No: 1, Text Type: N, H10


[188741382] It was reported that the torque wrench black tip guard broken off. Damage found when instruments returned to the office for inspection.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1818910-2020-00250
MDR Report Key9544760
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-01-03
Date of Report2019-12-10
Date of Event2019-12-10
Date Mfgr Received2020-01-24
Device Manufacturer Date2006-06-15
Date Added to Maude2020-01-03
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Manufacturer ContactKARA DITTY-BOVARD
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 465810988
Manufacturer CountryUS
Manufacturer Postal465810988
Manufacturer Phone6107428552
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 NameSIG FEM ADPT TORQUE WRENCH
Generic NameKNEE INSTRUMENT : TORQUE DEVICES
Product CodeHXC
Date Received2020-01-03
Returned To Mfg2019-12-17
Model Number96-1673
Catalog Number961673
Lot NumberA0606
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 2020-01-03

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