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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY MITEK LLC US 3.5MM SUTURE GRASPER; INSTRUMENT, LIGATURE PASSING AND KNOT TYING

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DEPUY MITEK LLC US 3.5MM SUTURE GRASPER; INSTRUMENT, LIGATURE PASSING AND KNOT TYING Back to Search Results
Catalog Number 214575
Medical Device Problem Codes Use of Device Problem (1670); Difficult to Open or Close (2921)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/15/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This report is being submitted in pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by depuy mitek or its employees that the report constitutes an admission that the device, depuy mitek, 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 medwatch, a follow-up medwatch will be filed as appropriate.H10 additional narrative: udi: (b)(4).The lot number was unknown.D4, g1, h4: the lot number was unknown; therefore, the expiration date, manufacturing site name and device manufacture date were unknown.E3: reporter is a j&j sales representative.Investigation summary: the device was received and evaluated.When performing the visual inspection, it could be observed that the device comes in used condition as expected.No broken pieces could be observed.When testing, the jaw cannot be opened or closed, it was found loose.Given that lot number was not provided, the manufacturing record evaluation (mre) review cannot be performed.If the lot number becomes available, the mre review will be performed.As part of depuy synthes mitek quality process all devices are manufactured, inspected, and released to approved specifications.According with the visual inspection result, this complaint can be confirmed.The possible root cause for this issue can be attributed to the repeated and constant use of the device and constant sterilization process, this can contribute to a device a non-opening/closing jaw.As per ifu: end of useful instrument life is generally determined by wear or damage from handling or surgical use.At this point in time, no corrective action is required, and no further action is warranted.However, depuy synthes mitek will continue to monitor additional complaint information for potential safety signals through complaint trending as part of post market surveillance.
 
Event or Problem Description
It was reported by the healthcare professional in france that the 3.5mm suture grasper device was non-functional.During in-house engineering evaluation, it was determined that the jaw could not be opened or closed; and that it was found loose.There was no procedure nor patient involvement reported.No additional information was provided.
 
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Brand Name
3.5MM SUTURE GRASPER
Common Device Name
INSTRUMENT, LIGATURE PASSING AND KNOT TYING
Manufacturer (Section D)
DEPUY MITEK LLC US
325 paramount drive
raynham MA 02767
Manufacturer Contact
kate karberg
325 paramount drive
raynham, MA 02767
3035526892
MDR Report Key17492160
Report Number1221934-2023-02987
Device Sequence Number7376538
Product Code HCF
UDI-Device Identifier10886705003822
UDI-Public10886705003822
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
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 Catalogue Number214575
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/28/2023
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/02/2023
Initial Report FDA Received Date08/09/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Patient SexUnknown
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