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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY SPINE INC CONDUIT STRAIGHT TLIF / PLIF; INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, LUMBAR

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DEPUY SPINE INC CONDUIT STRAIGHT TLIF / PLIF; INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, LUMBAR Back to Search Results
Catalog Number PET30101T
Device Problems Device-Device Incompatibility (2919); Material Twisted/Bent (2981)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 12/21/2023
Event Type  malfunction  
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: d1: conduit straight tlif / plif transforaminal / posterior lumbar interbody implant inserter outer shaft d9: complainant part is expected to be returned for manufacturer review/investigation, but has yet to be received.H3, h4, h6: the product was not returned to depuy synthes, however photos were provided for review.The photo investigation did not reveal the reported stripped condition for t handle inserter, however shaft shows the signs of usage.Review of provided photos only shows the product information and did not reveal the reported condition, and the cause of issue remains undetermined.Since the device was not returned, a dimensional inspection cannot be performed.The overall complaint was unconfirmed as the observed condition of the t handle inserter would not contribute to the complained device issue.Based on the investigation findings, potential cause not established and it has been determined that no corrective and/or preventative action is proposed.There is no indication that a design or manufacturing issue has caused the complaint condition.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.(b)(4).
 
Event Description
It was reported that on (b)(6) 2023, during postop inspection, it was noted that the inner threads on the conduit pluf inserter and inner shaft were damaged to the point of not functioning.Also, the plastic tip of the mallet was broken off, leaving the threads behind.There were no patient consequences reported.This report involves one conduit straight tlif / plif transforaminal / posterior lumbar interbody implant inserter outer shaft.This is report 1 of 3 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.H10 additional narrative: d10 h3, h6: the product was returned to depuy synthes for evaluation.The depuy synthes team conducted a visual inspection of the returned device.Visual analysis of the returned sample revealed that the inner threads near the proximal end was stripped.The device interaction allegation can attribute to the stripped condition.A functional test was performed, both devices pet30102t & pet30101t cannot be assembled correctly.The complaint condition was able to be replicated.A dimensional inspection was not performed as it is not applicable to the complaint condition.The observed condition was consistent as an end of life indicator for the device the overall complaint was confirmed as the observed condition of the t handle inserter would contribute to the complained device issue.There is no indication that a design or manufacturing issue has caused the complaint condition.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.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.Drawing/specifications reviewed current and manufactured revisions were reviewed.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
CONDUIT STRAIGHT TLIF / PLIF
Type of Device
INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, LUMBAR
Manufacturer (Section D)
DEPUY SPINE INC
325 paramount drive
raynham MA 02767
Manufacturer Contact
kate karberg
325 paramount drive
raynham, MA 02767
3035526892
MDR Report Key18503160
MDR Text Key332781411
Report Number1526439-2024-00617
Device Sequence Number1
Product Code MAX
UDI-Device Identifier10705034558097
UDI-Public(01)10705034558097
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K210728
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/12/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberPET30101T
Device Lot NumberNN185628
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Date Manufacturer Received02/08/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured01/11/2023
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
Treatment
HAMMER; T HANDLE INSERTER INNER SHAFT
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