MAUDE Adverse Event Report: SYNTHES GMBH TI TOMOFIX(TM) LATERAL DISTAL FEMUR PLATE-4 HOLES/LEFT; PLATE, FIXATION, BONE

Catalog Number 440.874S

Device Problem Appropriate Term/Code Not Available (3191)

Patient Problem Insufficient Information (4580)

Event Date 05/24/2023

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.Additional device product code: ktt.Complainant part is not expected to be returned for manufacturer review/investigation.Reporter is a j&j sales representative.Medical device problem (b)(4) used to capture reported issue of device not available/missing.Without a lot number the device history records review could not be completed.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.

Event Description

Device report from depuy synthes reports an event in peru as follows: it was reported that on (b)(6) 2023 surgery had to be suspended due to shortage of ti tomofix lateral distal femur plate-4 holes/left.The patient was in the operating room, under regional anesthesia.Surgery was rescheduled.The surgery was delayed for 48 hours due to reported event.This report is for one (1) ti tomofix(tm) lateral distal femur plate-4 holes/left this is report 1 of 1 for complaint (b)(4).

• Brand Name: TI TOMOFIX(TM) LATERAL DISTAL FEMUR PLATE-4 HOLES/LEFT
• Type of Device: PLATE, FIXATION, BONE
• Manufacturer (Section D): SYNTHES GMBH; eimattstrasse 3; oberdorf 4436 ; SZ 4436
• Manufacturer (Section G): SYNTHES SELZACH; bohackerweg 5; selzach 2545 ; SZ 2545
• Manufacturer Contact: kate karberg ; 1302 wrights lane east; west chester, PA 19380 ; 8472871282
• MDR Report Key: 17123259
• MDR Text Key: 317119710
• Report Number: 8030965-2023-07426
• Device Sequence Number: 1
• Product Code: HRS
• UDI-Device Identifier: 07611819245808
• UDI-Public: (01)07611819245808
• Combination Product (y/n): N
• Reporter Country Code: PE
• PMA/PMN Number: K141796
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Foreign,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

• Date FDA Received: 06/14/2023
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: 440.874S
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Date Manufacturer Received: 05/25/2023
• 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
• Patient Outcome(s): Required Intervention
• Patient Sex: Male