MAUDE Adverse Event Report: DEPUY IRELAND - 9616671 ATTUNE REVISION TIBIAL BLOCK R; RESECTION BLOCKS/DEVICES

Model Number 2506-10-112

Device Problem Physical Resistance/Sticking (4012)

Patient Problem No Code Available (3191)

Event Date 08/10/2020

Event Type  malfunction  

Manufacturer Narrative

Product complaint # (b)(4).If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.

Event Description

It was reported that when they were applying the proximal tibia cutting instrument, one of the fixation pins got stuck in the pin hole while they were attempting to drill the pin into the hole.The mallet had to be used to pound the pin through the hole.A new pin was inserted into a different hole.A surgical delay of one to two minutes.

Manufacturer Narrative

Product complaint # (b)(4).Investigation summary: the device associated with this report was not returned for evaluation.The investigation could not draw any conclusions about the reported event without the device to examine.Depuy considers the investigation closed.Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary.

• Brand Name: ATTUNE REVISION TIBIAL BLOCK R
• Type of Device: RESECTION BLOCKS/DEVICES
• Manufacturer (Section D): DEPUY IRELAND - 9616671; loughbeg ringaskiddy co.; cork ; EI
• MDR Report Key: 10442478
• MDR Text Key: 204027137
• Report Number: 1818910-2020-18574
• Device Sequence Number: 1
• Product Code: HTZ
• UDI-Device Identifier: 10603295436232
• UDI-Public: 10603295436232
• Combination Product (y/n): N
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,health
• Type of Report: Initial,Followup
• Report Date: 08/10/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 08/24/2020
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Model Number: 2506-10-112
• Device Catalogue Number: 250610112
• Device Lot Number: SO2034847
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 09/21/2020
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1