MAUDE MDR 9872032

MDR report key
9872032
Report number
1526439-2020-00751
Event key
0
Event type
3
Date received
2020-03-24
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
KARA DITTY-BOVARD
Address
325 PARAMOUNT DRIVE RAYNHAM MA 02767 US
Phone
610-610-6103
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1EXPEDIUM SPINE SYSTEM BALL TIP FEELER (STRAIGHT) 10-100MMPROBEDEPUY SPINE INCHXB299704125299704125PU109649R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-240

Event Narratives#

N

Patient 1

THE COMPLAINT DEVICE WAS NOT RECEIVED FOR INVESTIGATION. THE IMAGE(S) WERE REVIEWED AND THE COMPLAINT CONDITION COULD BE CONFIRMED. IT WAS NOTICED THAT THE BALL TIP FEELER SHAFT IS SEPARATED FROM THE HANDLE, THE FAILURE OCCURRED AT THE WELD CONNECTION BETWEEN THE TIP AND THE HANDLE. SINCE THE DEVICE WAS NOT RETURNED, A DIMENSIONAL INSPECTION AND A FUNCTIONAL TEST WERE NOT ABLE TO BE PERFORMED. A DEFINITIVE ASSIGNABLE ROOT CAUSE COULD NOT BE DETERMINED BASED ON THE PROVIDED INFORMATION. DURING THE INVESTIGATION NO PRODUCT DESIGN ISSUES OR DISCREPANCIES WERE OBSERVED (BASED ON THE IMAGES) THAT MAY HAVE CONTRIBUTED TO THE COMPLAINT CONDITION. ADDITIONAL MONITORING FOR ANY POTENTIAL SAFETY SIGNALS WILL BE CONDUCTED THROUGH COMPLAINT TRENDING AND OTHER POST MARKET SAFETY SURVEILLANCE ACTIVITIES. BASED ON THE INVESTIGATION FINDINGS, IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND/OR PREVENTATIVE ACTION IS PROPOSED. DEVICE HISTORY LOT A REVIEW OF THE RECEIVING INSPECTION (RI) FOR BALL TIP FEELER, ST WAS CONDUCTED IDENTIFYING THAT LOT NUMBER PU109649 WAS RELEASED IN A SINGLE BATCH. BATCH UNITS WERE RELEASED ON 12 AUG 2016 WITH NO DISCREPANCIES. AS A RESULT, THE RI IDENTIFIED NO ISSUES DURING THE MANUFACTURING AND RELEASE OF THIS DEVICE THAT COULD HAVE CONTRIBUTED TO THE PROBLEM REPORTED BY THE CUSTOMER. THE RI IDENTIFIED NO ISSUES DURING THE MANUFACTURING AND RELEASE OF THIS DEVICE THAT COULD HAVE CONTRIBUTED TO THE PROBLEM REPORTED BY THE CUSTOMER. 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.

D

Patient 1

DEVICE REPORT FROM SYNTHES REPORTS AN EVENT IN (B)(6) AS FOLLOWS: IT WAS REPORTED THAT ON AN UNKNOWN DATE, THE PEDICLE FEELER UNEXPECTEDLY DISASSEMBLED DURING A ROUTINE CLEANING OPERATION. NO FURTHER INFORMATION PROVIDED. THIS REPORT IS FOR ONE (1) EXPEDIUM SPINE SYSTEM BALL TIP FEELER (STRAIGHT) 10-100MM PLUS OR MINUS 4 PERCENT. THIS IS REPORT 1 OF 1 FOR (B)(4).