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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITH & NEPHEW, INC. HEALICOIL PK 4.5MM W/ ULTRA TAPE BLUE; PROSTHESIS, RIB REPLACEMENT

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SMITH & NEPHEW, INC. HEALICOIL PK 4.5MM W/ ULTRA TAPE BLUE; PROSTHESIS, RIB REPLACEMENT Back to Search Results
Catalog Number 72203981
Device Problem Material Fragmentation (1261)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 05/18/2019
Event Type  malfunction  
Event Description
It was reported that upon insertion the anchor shredded it's thread.After which the surgeon determined that the bone quality was very hard and possibly the issue cause.They used a threaded tap for the second anchor and had no issues.The biggest concern was the fragments of peek left behind on this anchor, which the surgeon cleaned up.No patient injury or significant delay were reported.No additional bone hole was necessary.
 
Manufacturer Narrative
One 72203981 healicoil pk 4.5mm suture anchor used for treatment, was not returned for evaluation.Due to product unavailability, the complaint could not be visually evaluated.If objective evidence, relevant information, packaging or product becomes available, the complaint will certainly be revisited.Factors that may affect device performance include: device ability, surgical ability, procedure location and tissue condition.Influences that could compromise product performance or integrity that are unrelated to manufacture include: 1.Damaged or use of other than recommended prep instrument size or types.2.Pressure or excess torque applied.3.Inadequate bone quality resulting in anchor pullout or loss of fixation.4.Unexpected bone condition/density.5.Breakage and damage can occur due to use of sharp instruments to manage or control the suture.If more torque is required to insert the anchor, stop and ensure that the hole size and depth are correct for the bone conditions encountered.It is the responsibility of the surgeon to determine the patient¿s bone condition, appropriately prepare the insertion site, and determine the suitability of the implant for the procedure.Breakage of the suture anchors can occur if insertion sites are not prepared with appropriate instrumentation prior to implantation.Use of excessive force during insertion can cause failure of the suture anchor or insertion device.Recommended prep instrument for the 4.5mm anchor used on normal bone condition is a 3.8mm tapered awl.Product met specifications upon release to distribution.Complaint history review found no other report for this lot.
 
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Brand Name
HEALICOIL PK 4.5MM W/ ULTRA TAPE BLUE
Type of Device
PROSTHESIS, RIB REPLACEMENT
Manufacturer (Section D)
SMITH & NEPHEW, INC.
130 forbes boulevard
mansfield MA 02048
MDR Report Key8690869
MDR Text Key147868687
Report Number1219602-2019-00683
Device Sequence Number1
Product Code MDI
UDI-Device Identifier00885554032123
UDI-Public00885554032123
Combination Product (y/n)N
PMA/PMN Number
K113294
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type foreign,health professional,o
Type of Report Initial,Followup
Report Date 07/04/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received06/12/2019
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number72203981
Device Lot Number2021404
Was Device Available for Evaluation? No
Date Manufacturer Received07/04/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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