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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH K-WIRE Ø1 L150 SST 10U; WIRE, SURGICAL

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SYNTHES GMBH K-WIRE Ø1 L150 SST 10U; WIRE, SURGICAL Back to Search Results
Catalog Number 292.100.10
Device Problem Material Deformation (2976)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 01/27/2023
Event Type  malfunction  
Event Description
Device report from synthes reports an event in japan as follows: it was reported that on (b)(6) 2023, before the surgery, it was found that seven out of ten of the products in question were bent.They were bent in the same position as previously reported in (b)(4) no further information is available.This report involves one k-wire ø1 l150 sst 10u.This is report 1 of 1 for (b)(4).
 
Manufacturer Narrative
Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.If the information is unknown, not available or does not apply, the section/field of the form is left blank.Additional narrative: complainant part is expected to be returned for manufacturer review/investigation, but has yet to be received.Reporter is a j&j employee.Device is not distributed in the united states, but is similar to device marketed in the usa.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.
 
Manufacturer Narrative
Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.H4: manufacture date added.The product was returned to depuy synthes for evaluation.The depuy synthes team conducted a visual inspection of the returned device.Only seven wires were returned from the package containing ten.Visual analysis of the returned sample revealed that the seven k-wire ø1 l150 sst 10u were bent from the shaft.No other issues were found.A dimensional inspection for the k-wire ø1 l150 sst 10u was not performed as is not applicable to the complaint condition.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.The overall complaint was confirmed as the observed condition of the k-wire ø1 l150 sst 10u would contribute to the complained device issue.There is no indication that a design or manufacturing issue has caused the complaint condition and hence the root cause cannot be determined.Based on the investigation findings, it has been determined that no corrective and/or preventative action is proposed.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.Drawing/specifications reviewed? yes, reviewed.Device history review part #: 292.100.10.Lot #: 806p795.Manufacturing site: balsthal.Release to warehouse date: 18 may 2022.A manufacturing record evaluation was performed for the finished device 292.100.10 lot #806p795, and no non-conformances were identified.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.
 
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Brand Name
K-WIRE Ø1 L150 SST 10U
Type of Device
WIRE, SURGICAL
Manufacturer (Section D)
SYNTHES GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
Manufacturer (Section G)
WERK BALSTHAL (CH)
dornacherstrasse 20
balsthal 4710
SZ   4710
Manufacturer Contact
kate karberg
1302 wright lane east
west chester, PA 19380
3035526892
MDR Report Key16389424
MDR Text Key310163993
Report Number8030965-2023-01966
Device Sequence Number1
Product Code LRN
UDI-Device Identifier07611819321373
UDI-Public(01)07611819321373
Combination Product (y/n)N
Reporter Country CodeJA
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Company Representative
Reporter Occupation Other
Type of Report Initial,Followup
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number292.100.10
Device Lot Number806P795
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 01/27/2023
Initial Date FDA Received02/16/2023
Supplement Dates Manufacturer Received03/06/2023
Supplement Dates FDA Received03/21/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured05/18/2022
Is the Device Single Use? Yes
Type of Device Usage Unknown
Patient Sequence Number1
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