MAUDE Adverse Event Report: ARTHREX, INC. DISPS KIT,TRANS-TIB ACL W/ SAWBLD; SAW BLADE

Model Number DISPS KIT,TRANS-TIB ACL W/ SAWBLD

Device Problem Component Missing (2306)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Date 08/18/2023

Event Type  malfunction  

Manufacturer Narrative

The contribution of the device to the reported event could not be determined as the device was not returned for evaluation.The root cause of the event could not be determined from the information available and without device evaluation.If the device becomes available for evaluation, a follow-up report will be submitted.

Event Description

On 8/18/2023, it was reported by a sales representative via sems that an ar-1897s transtibial acl disposables kit had 2 of 5 guide pins that did not come with the beath pin in them.This was discovered upon opening the package during a procedure, with no reported adverse event or patient harm.Additional information requested.

• Brand Name: DISPS KIT,TRANS-TIB ACL W/ SAWBLD
• Type of Device: SAW BLADE
• Manufacturer (Section D): ARTHREX, INC.; 1370 creekside boulevard; naples FL 34108 1945
• Manufacturer (Section G): ARTHREX, INC.; 1370 creekside boulevard; naples FL 34108 1945
• Manufacturer Contact: emily shafer ; 8009337001
• MDR Report Key: 17746312
• MDR Text Key: 323416580
• Report Number: 1220246-2023-07903
• Device Sequence Number: 1
• Product Code: GFA
• UDI-Device Identifier: 00888867022454
• UDI-Public: 00888867022454
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: EXEMPT
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Distributor
• Reporter Occupation: Administrator/Supervisor
• Type of Report: Initial
• Report Date: 09/14/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 09/14/2023
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Model Number: DISPS KIT,TRANS-TIB ACL W/ SAWBLD
• Device Catalogue Number: AR-1897S
• Device Lot Number: 15070669
• Was Device Available for Evaluation?: Yes
• Date Manufacturer Received: 08/18/2023
• Date Device Manufactured: 03/21/2023
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1