11CM LONG ATTACH LONG-G1

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2020-03-19 for 11CM LONG ATTACH LONG-G1 manufactured by Depuy Synthes Products Llc.

Event Text Entries

[184447288] Device was used for treatment, not diagnosis. If information is obtained that was not available for this medwatch, a supplemental medwatch report will be filed as appropriate. Device manufacture date: the device manufacture date is currently unavailable. As of this date, the device has not been returned for evaluation; therefore, the reported condition cannot be confirmed and/or duplicated. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[184447289] It was reported that during pre-surgery, it was discovered that the attachment device was overheating. There was no delay to the surgical procedure as an identical spare device was available for use. There was no patient involvement reported. There were no reports of injuries, medical intervention or prolonged hospitalization. All available information has been disclosed. If additional information should become available, a supplemental medwatch report will be submitted accordingly.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1045834-2020-00522
MDR Report Key9856196
Report SourceUSER FACILITY
Date Received2020-03-19
Date of Report2020-03-13
Date of Event2020-03-12
Date Mfgr Received2020-03-20
Device Manufacturer Date2014-10-17
Date Added to Maude2020-03-19
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 Street4500 RIVERSIDE DRIVE
Manufacturer CityPALM BEACH GARDENS FL 33410
Manufacturer CountryUS
Manufacturer Postal33410
Manufacturer Phone6103142063
Manufacturer G1DEPUY SYNTHES PRODUCTS LLC
Manufacturer Street4500 RIVERSIDE DRIVE
Manufacturer CityPALM BEACH GARDENS FL 33410
Manufacturer CountryUS
Manufacturer Postal Code33410
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name11CM LONG ATTACH
Generic NameMOTOR, DRILL, ELECTRIC
Product CodeHBC
Date Received2020-03-19
Model NumberLONG-G1
Catalog NumberLONG-G1
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDEPUY SYNTHES PRODUCTS LLC
Manufacturer Address4500 RIVERSIDE DRIVE PALM BEACH GARDENS FL 33410 US 33410


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-19

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