INSERTER/EXTRACTOR FOR CHILD & ADOLESCENT OSTEOTOMY PLATES 332.353

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2020-03-26 for INSERTER/EXTRACTOR FOR CHILD & ADOLESCENT OSTEOTOMY PLATES 332.353 manufactured by Wrights Lane Synthes Usa Products Llc.

Event Text Entries

[185915698] (b)(6). The device has been received, the investigation is in progress, no conclusion could be drawn at the time of filing this report. 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


[185915699] It was reported on (b)(6) 2020, it was noticed that both screws in the two (2) inserter/extractor for child hip plate were bound or cross-threaded making them unusable. The sales consultant attempted to unscrew the one in the infant inserter/extractor, but the screw head snapped off. This did not impact a surgery, as the sales consultant was checking the set beforehand. There was no patient involvement. This report involves one (1) inserter/extractor for child & adolescent osteotomy plates. This is report 2 of 2 for (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2939274-2020-01517
MDR Report Key9882469
Report SourceCOMPANY REPRESENTATIVE
Date Received2020-03-26
Date of Report2020-03-04
Date of Event2020-03-04
Date Mfgr Received2020-03-04
Date Added to Maude2020-03-26
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 G1MONUMENT
Manufacturer Street1101 SYNTHES AVENUE
Manufacturer CityMONUMENT CO 80132
Manufacturer CountryUS
Manufacturer Postal Code80132
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameINSERTER/EXTRACTOR FOR CHILD & ADOLESCENT OSTEOTOMY PLATES
Generic NameEXTRACTOR
Product CodeHWB
Date Received2020-03-26
Returned To Mfg2020-03-25
Model Number332.353
Catalog Number332.353
Lot Number7930179
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrN
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 2020-03-26

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