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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: OBERDORF SYNTHES PRODUKTIONS GMBH HOLDING CLAMP 1.6MM; BONE, PLATE

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OBERDORF SYNTHES PRODUKTIONS GMBH HOLDING CLAMP 1.6MM; BONE, PLATE Back to Search Results
Model Number 395.126
Device Problem Device-Device Incompatibility (2919)
Patient Problem No Patient Involvement (2645)
Event Type  malfunction  
Manufacturer Narrative
(b)(4).Reporter is company representative product was not returned.Based on the information available, it has been determined that no corrective and preventative action is proposed.This complaint will be accounted for and monitored via post market surveillance activities.If additional information is made available, the investigation will be updated as applicable.Device history: part: 395.126, lot: 1362940, manufacturing site: (b)(4), release to warehouse date: 15 june 2005.A manufacturing record evaluation was performed for the finished device lot number, and no non-conformances were identified.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.
 
Event Description
Device report from synthes reports an event in (b)(6) as follows: it was reported during an inspection of the minifixer system, it is noted that the holding and connecting clamps do not function appropriately with the other devices.No patient involvement.This is report 2 of 10 for (b)(4).This complaint is linked to (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.H3, h6: a product investigation was conducted.Visual inspection: holding clamp ø1.6 f/mini-ext-fix (part# 395.126, lot# 1362940, qty# 1) was returned and received at us cq.Upon visual inspection at cq, it is observed that the device looks good without any damage.Functional testing: complete functional testing of the device received was not performed at cq as the mating devices were not returned at cq.But all the components of the device were disassembled and assembled as intended without any issues.The complaint replication was unable to perform with the returned device(s).Dimensional inspection: dimensional inspection of the connecting rod hole in the clamp was performed at cq.The diameter of the hole of the clamp was measured and is within specification as per the relevant drawing.Document/specification review: the relevant drawings were reviewed during the investigation.No design issues or discrepancies were noticed.Investigation conclusion: the complaint condition cannot be confirmed for the holding clamp ø1.6 f/mini-ext-fix (part# 395.126, lot# 1362940).A definitive root cause for the reported problem cannot be determined.There were no issues during the manufacture of this product that would contribute to this complaint condition.During the investigation, no product design issues, or discrepancies were observed that may have contributed to the complaint condition.Based upon these results, 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.Therefore, it has been determined that no corrective and/or preventive action is proposed.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.
 
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 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.
 
Manufacturer Narrative
Product complaint # (b)(4).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.H3, 4, h6: device history lot part: 395.126, lot: 1362940, manufacturing site: hägendorf, release to warehouse date: 15 june 2005.A manufacturing record evaluation was performed for the finished device lot number, and no non-conformances were identified.Investigation summary: background: 04/06/2020: updated event description: performing a review of the falange minifixer system, it is evident that the system bars do not enter the patella properly.For now, the system is blocked for operation due to incomplete key pieces.395.133 * (b)(4) units, 395.125 * (b)(4) units, 395.126 * (b)(4) units.This complaint involves (b)(4) devices.Investigation flow: functional visual inspection: holding clamp ø1.6 f/mini-ext-fix (part# 395.126, lot# 1362940, qty# (b)(4)) was returned and received at us cq.Upon visual inspection at cq, it is observed that the device looks good without any damage.Functional testing: complete functional testing of the device received was not performed at cq as the mating devices were not returned at cq.But all the components of the device were disassembled and assembled as intended without any issues.Can the complaint be replicated with the returned device(s)? unable to perform dimensional inspection: (gauge pins: gp29/ gp32) dimensional inspection of the connecting rod hole in the clamp was performed at cq.The diameter of the hole of the clamp was measured and is within specification.Complaint was not confirmed.Investigation conclusion the complaint condition cannot be confirmed for the holding clamp ø1.6 f/mini-ext-fix (part# 395.126, lot# 1362940).A definitive root cause for the reported problem cannot be determined.There were no issues during the manufacture of this product that would contribute to this complaint condition.During the investigation, no product design issues, or discrepancies were observed that may have contributed to the complaint condition.Based upon these results, 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.Therefore, it has been determined that no corrective and/or preventive action is proposed.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
HOLDING CLAMP 1.6MM
Type of Device
BONE, PLATE
Manufacturer (Section D)
OBERDORF SYNTHES PRODUKTIONS GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
MDR Report Key9985415
MDR Text Key188530690
Report Number8030965-2020-03010
Device Sequence Number1
Product Code JEY
UDI-Device Identifier10886982200181
UDI-Public(01)10886982200181
Combination Product (y/n)N
PMA/PMN Number
K033158
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Type of Report Initial,Followup,Followup,Followup
Report Date 04/01/2020
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 Number395.126
Device Catalogue Number395.126
Device Lot Number1362940
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/07/2020
Initial Date Manufacturer Received 04/01/2020
Initial Date FDA Received04/22/2020
Supplement Dates Manufacturer Received01/15/2021
04/06/2021
05/07/2021
Supplement Dates FDA Received01/20/2021
04/06/2021
06/03/2021
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Treatment
CONNEC-CLAMP Ø3 F/MINI-EXT-FIX; CONNEC-CLAMP Ø3 F/MINI-EXT-FIX; HOLDING CLAMP Ø1.25 F/MINI-EXT-FIX; HOLDING CLAMP Ø1.6 F/MINI-EXT-FIX; HOLDING CLAMP Ø1.6 F/MINI-EXT-FIX; HOLDING CLAMP Ø1.6 F/MINI-EXT-FIX; HOLDING CLAMP Ø1.6 F/MINI-EXT-FIX; HOLDING CLAMP Ø1.6 F/MINI-EXT-FIX; HOLDING CLAMP Ø1.6 F/MINI-EXT-FIX
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