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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY IRELAND - 9616671 ATTUNE CR FEM RT SZ 5 NAR CEM; ATTUNE IMPLANT : KNEE FEMORAL

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DEPUY IRELAND - 9616671 ATTUNE CR FEM RT SZ 5 NAR CEM; ATTUNE IMPLANT : KNEE FEMORAL Back to Search Results
Model Number 1504-00-225
Medical Device Problem Codes Tear, Rip or Hole in Device Packaging (2385); Device Contaminated During Manufacture or Shipping (2969)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 05/31/2022
Type of Reportable Event Malfunction
Additional 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 or Problem Description
It was reported that the inner packaging was broken on the corner on top under the paper cover.Damage was discovered after the cover paper was unmoved.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by depuy synthes joint reconstruction, or its employees that the report constitutes an admission that the product, depuy synthes joint reconstruction, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.
 
Event or Problem Description
There was a surgical delay of 5 minutes.
 
Additional Manufacturer Narrative
Product complaint # : (b)(4).Investigation summary: the device associated with this complaint was received for examination.Examination found the inner plastic package damaged/cracked, confirming the reported allegation.The device was sent to depuy cork mfg site for further analysis.There is not enough evidence to confirm the sterility was compromised.Depuy synthes considers the investigation closed at this time.Should additional information be received, the information will be reviewed and the investigation may be re-opened as necessary.Device history lot : a manufacturing record evaluation was performed for the finished device (lot: 3738438, p/n: 150400225) number, and no non-conformances or manufacturing irregularities related to the malfunction were identified.
 
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Brand Name
ATTUNE CR FEM RT SZ 5 NAR CEM
Common Device Name
ATTUNE IMPLANT : KNEE FEMORAL
Manufacturer (Section D)
DEPUY IRELAND - 9616671
loughbeg ringaskiddy co.
cork
EI 
Manufacturer (Section G)
DEPUY IRELAND 9616671
loughbeg, ringaskiddy co.
cork
EI  
Manufacturer Contact
kate karberg
700 orthopaedic dr.
warsaw, IN 46581-0988
3035526892
MDR Report Key14685838
Report Number1818910-2022-10843
Device Sequence Number14611376
Product Code NJL
UDI-Device Identifier10603295041283
UDI-Public10603295041283
Combination Product (Y/N)N
Initial Reporter CountrySZ
PMA/510(K) Number
P830055
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 06/14/2022
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
Operator of Device Health Professional
Device Model Number1504-00-225
Device Catalogue Number150400225
Device Lot Number3738438
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/31/2022
Supplement Date Received by Manufacturer07/05/2022
09/29/2022
Initial Report FDA Received Date06/14/2022
Supplement Report FDA Received Date07/06/2022
10/03/2022
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/04/2022
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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