Current information is insufficient to permit a conclusion as to the cause of the event.There are warnings in the package insert that this type of an event can occur.Under care and handling of instruments, it states, "inspect the instrument case and instruments for damage upon receipt and after each use and cleaning." under cleaning and decontamination, number 1 states, "thoroughly clean instruments until visibly clean, repeating as necessary, prior to initial sterilization and as soon as possible after use." this report is number 1 of 3 mdrs filed for the same event (reference 1825034-2016-01712 / 01715 / 01716).Device requested, not yet received.
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