BLADE/SCREW GUIDE SLEEVE 03.037.017

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 2020-03-30 for BLADE/SCREW GUIDE SLEEVE 03.037.017 manufactured by Wrights Lane Synthes Usa Products Llc.

Event Text Entries

[185545151] 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


[185545152] It was reported that on (b)(6) 2020, during an unknown hip procedure, the trochanteric femoral nail advanced (tfna) helical blade impactor had jammed inside the sleeve. The surgeon used another inserter to force through the trocar in order to finish the case. The surgeon did not use another guide sleeve to complete the procedure. The procedure was successfully completed with 2 minutes surgical delay. There was no adverse consequence on the patient reported. Concomitant devices reported: helical blade inserter (part number 03. 037. 024, lot t116411), insertion instrument: trocar (part number unknown, lot unknown, quantity unknown), nail head elements: tfna helical blade (part number unknown, lot unknown, quantity unknown). This report involves one blade/screw guide sleeve. This is report 2 of 2 for (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2939274-2020-01588
MDR Report Key9898324
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-30
Date of Report2020-03-06
Date of Event2020-03-06
Date Mfgr Received2020-03-06
Date Added to Maude2020-03-30
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 Street1302 WRIGHTS LANE EAST
Manufacturer CityWEST CHESTER PA 19380
Manufacturer CountryUS
Manufacturer Postal19380
Manufacturer Phone6103142063
Manufacturer G1WERK BETTLACH (CH)
Manufacturer StreetMURACHERSTRASSE 3
Manufacturer CityBETTLACH 2544
Manufacturer CountrySZ
Manufacturer Postal Code2544
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBLADE/SCREW GUIDE SLEEVE
Generic NameGUIDE
Product CodeFZX
Date Received2020-03-30
Returned To Mfg2020-03-26
Model Number03.037.017
Catalog Number03.037.017
Lot NumberL629391
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 2020-03-30

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