MAUDE Adverse Event Report: SYNTHES GMBH DPS HAERTOE CCI LRG KIT 1.60 K-WIRE/ S; STAPLE, FIXATION, BONE

Catalog Number 46.239.002

Device Problem Adverse Event Without Identified Device or Use Problem (2993)

Patient Problem Insufficient Information (4580)

Event Type  Injury  

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.H10 additional narrative: d9: complainant part is not expected to be returned for manufacturer review/investigation.E3: reporter is a j&j employee.H3, h4, h6: without a lot number the device history records review could not be completed.Product was not returned.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.

Event Description

It was reported that on (b)(6) 2023, several patients had difficulty healing incision wounds.One patient experienced the implant backing out.The implant in question is hammertoe cci.The patient required a revision surgery.It was notified about multiple incidents in one conversation.There wasn't dialogue about number of patients, but it was stated that it was several.The implant was hammertoe cci in both sizes.This report is for one (1) dps haertoe cci lrg kit 1.60 k-wire/ s this is report 2 of 2 for complaint (b)(4).This report captures the reported several patients, while related complaint pc-001485735 captures the one patient who experienced the implant backing out.

• Brand Name: DPS HAERTOE CCI LRG KIT 1.60 K-WIRE/ S
• Type of Device: STAPLE, FIXATION, BONE
• Manufacturer (Section D): SYNTHES GMBH; eimattstrasse 3; oberdorf 4436 ; SZ 4436
• Manufacturer (Section G): MONUMENT; 1101 synthes avenue; monument CO 80132
• Manufacturer Contact: kate karberg ; 1302 wrights lane east; west chester, PA 19380 ; 8472871282
• MDR Report Key: 18377629
• MDR Text Key: 331140693
• Report Number: 8030965-2023-16057
• Device Sequence Number: 1
• Product Code: JDR
• UDI-Device Identifier: 00810633022054
• UDI-Public: (01)00810633022054
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K191463
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Health Professional,Company Representative
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Device Catalogue Number: 46.239.002
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 11/29/2023
• Initial Date FDA Received: 12/21/2023
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: Yes
• Type of Device Usage: Unknown
• Patient Sequence Number: 1
• Treatment: DPS HAERTOE CCI STD KIT 1.25 K-WIRE/ -S
• Patient Outcome(s): Required Intervention