PINN ESC LINER EXTRACTOR TIP 2218-00-010 221800010

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 2020-02-27 for PINN ESC LINER EXTRACTOR TIP 2218-00-010 221800010 manufactured by Depuy Orthopaedics Inc Us.

Event Text Entries

[186993860] Product complaint # (b)(4). Investigation summary ==> the examination of the returned instrument confirmed the complaint. It was also observed that the tip is grossly deformed and the very tip has fractured with a small portion of the tip missing. 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, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1818910-2020-06267
MDR Report Key9765082
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-02-27
Date of Report2020-02-12
Date of Event2020-01-01
Date Mfgr Received2020-02-12
Device Manufacturer Date2018-03-23
Date Added to Maude2020-02-27
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 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 NamePINN ESC LINER EXTRACTOR TIP
Generic NameHIP INSTRUMENTS : EXTRACTION INSTRUMENTS
Product CodeHWB
Date Received2020-02-27
Model Number2218-00-010
Catalog Number221800010
Lot NumberNW218829
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDEPUY ORTHOPAEDICS INC US
Manufacturer Address700 ORTHOPAEDIC DRIVE WARSAW IN 465810988 US 465810988


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-27

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