BONE SPREADER WITH 8MM BLADE MEDIUM HANDLE-SOFT RATCHET 399.097

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-03-23 for BONE SPREADER WITH 8MM BLADE MEDIUM HANDLE-SOFT RATCHET 399.097 manufactured by Wrights Lane Synthes Usa Products Llc.

Event Text Entries

[186755544] Complainant part is not expected to be returned for manufacturer review/investigation. Initial reporter is a synthes sales representative. The investigation could not be completed; no conclusion could be drawn, as no product was received. Based on the information available, it has been determined that no corrective and/or preventative action is proposed. This complaint will be accounted for and monitored via post market surveillance activities. If additional information is made available, the investigation will be updated as applicable. Device was used for treatment, not diagnosis. 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


[186755545] Device report from synthes canada reports an event as follows: it was reported the teeth of the tomofix laminar spreader are worn down. It was noticed by scrub nurse and a different spreader was used instead. There was no patient consequence or surgical delay. This report is for a tomofix laminar spreader. This is report 1 of 1 for (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2939274-2020-01451
MDR Report Key9864850
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-03-23
Date of Report2020-02-24
Date Mfgr Received2020-02-24
Date Added to Maude2020-03-23
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 Street1302 WRIGHTS LANE EAST
Manufacturer CityWEST CHESTER PA 19380
Manufacturer CountryUS
Manufacturer Postal19380
Manufacturer Phone6103142063
Manufacturer G1BRANDYWINE
Manufacturer Street1303 GOSHEN PARKWAY
Manufacturer CityWEST CHESTER PA 19380
Manufacturer CountryUS
Manufacturer Postal Code19380
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBONE SPREADER WITH 8MM BLADE MEDIUM HANDLE-SOFT RATCHET
Generic NameFORCEPS
Product CodeHTD
Date Received2020-03-23
Model Number399.097
Catalog Number399.097
Lot Number5006212
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerWRIGHTS LANE SYNTHES USA PRODUCTS LLC
Manufacturer Address1302 WRIGHTS LANE EAST WEST CHESTER PA 19380 US 19380


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-23

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