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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITH & NEPHEW, INC. DRILL GDE SPIKED TIP 6X3.5; ACCESSORIES,ARTHROSCOPIC

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SMITH & NEPHEW, INC. DRILL GDE SPIKED TIP 6X3.5; ACCESSORIES,ARTHROSCOPIC Back to Search Results
Model Number 7209500
Device Problem Corroded (1131)
Patient Problem No Patient Involvement (2645)
Event Date 08/11/2020
Event Type  malfunction  
Event Description
It was reported that, the newly purchased "drill guide spiked tip (6x3.5)" was rusty.No case reported; therefore, there was no patient involvement.All available information has been disclosed.If additional information should become available, a supplemental report will be submitted accordingly.
 
Manufacturer Narrative
H10 h3.H6: the reported device was received for evaluation.There was a relationship found between the device and the reported event.A complaint history review found no similar reported events.A review of device records showed there were no indications to suggest that the product did not meet manufacturing specification upon release for distribution.A risk management review found that the reported failure and/or harm was documented appropriately, and there were no indications to suggest the anticipated risk is not adequate.A visual inspection of the returned device found that it is not in its original packaging.The device has discoloration around the hub on the proximal end of the device.An assessment of the customer provided images shows the complaint device, with the discoloration around the hub as well as another device with discoloration near the distal tip.The complaint was confirmed, and the root cause could not be determined.Factors that may have contributed to the reported event include material degradation from repeated sterilization or improper cleaning techniques.Please refer to the instructions for use for recommendations on proper use of the device and potential troubleshooting methods to prevent future reoccurrence of the reported event.No containment or corrective actions are recommended at this time.
 
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Brand Name
DRILL GDE SPIKED TIP 6X3.5
Type of Device
ACCESSORIES,ARTHROSCOPIC
Manufacturer (Section D)
SMITH & NEPHEW, INC.
130 forbes blvd.
mansfield MA 02048
Manufacturer (Section G)
SMITH & NEPHEW, INC.
130 forbes blvd.
mansfield MA 02048
Manufacturer Contact
holly topping
7000 west william cannon drive
austin, TX 78735
5123913905
MDR Report Key10788040
MDR Text Key214654205
Report Number1219602-2020-01769
Device Sequence Number1
Product Code NBH
UDI-Device Identifier03596010474599
UDI-Public03596010474599
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,User Facility,Company Representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 11/28/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number7209500
Device Catalogue Number7209500
Device Lot Number50818975
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 10/13/2020
Initial Date FDA Received11/04/2020
Supplement Dates Manufacturer Received11/23/2023
Supplement Dates FDA Received11/28/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured07/26/2019
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
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