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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITH & NEPHEW, INC. BROACH HANDLE; PROSTHESIS, HIP, FEMORAL COMPONENT, CEMENTED, METAL

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SMITH & NEPHEW, INC. BROACH HANDLE; PROSTHESIS, HIP, FEMORAL COMPONENT, CEMENTED, METAL Back to Search Results
Model Number 71364007
Device Problems Fitting Problem (2183); Incomplete or Inadequate Connection (4037)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/29/2021
Event Type  malfunction  
Event Description
It was reported that during thr surgery, the broach handle did not gripped on to instruments.A smith and nephew back up device was available.No injury to patient or delay reported.
 
Manufacturer Narrative
H3, h6: the device, used in treatment, was returned for evaluation.A visual inspection was performed and confirmed the broach handle has worn locking mechanism causing it to operate properly.Burrs and gouges on the device indicate signs of excessive wear.A review of the device history records for the listed batch did not reveal any deviation from the standard manufacturing processes.At this time, we have no reason to suspect that the product failed to meet any product specifications at the time of manufacture.A review of the complaint history for the listed part revealed no prior complaints for the listed failure mode with the same batch number.This device is a reusable instrument that can be exposed to numerous surgeries; damage from repeated use can occur.Damage from prolonged use, misuse or rough handling are likely probable causes of the reported event.We recommend that all reusable instruments be routinely inspected for wear and damage and replaced as necessary.Based on this investigation, the need for corrective action is not indicated.Should additional information be received, the complaint will be reopened.No further investigation warranted for this complaint; however we will continue to monitor for future complaints and investigate as necessary.We consider this investigation closed.
 
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Brand Name
BROACH HANDLE
Type of Device
PROSTHESIS, HIP, FEMORAL COMPONENT, CEMENTED, METAL
Manufacturer (Section D)
SMITH & NEPHEW, INC.
1450 brooks rd.
memphis TN 38116
MDR Report Key11828823
MDR Text Key250769822
Report Number1020279-2021-04343
Device Sequence Number1
Product Code JDG
UDI-Device Identifier03596010199232
UDI-Public03596010199232
Combination Product (y/n)N
PMA/PMN Number
K123598
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional
Type of Report Initial,Followup
Report Date 06/10/2021
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 Number71364007
Device Catalogue Number71364007
Device Lot Number08GM15775
Was Device Available for Evaluation? Yes
Initial Date Manufacturer Received 04/29/2021
Initial Date FDA Received05/14/2021
Supplement Dates Manufacturer Received06/08/2021
Supplement Dates FDA Received06/10/2021
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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