MAUDE Adverse Event Report: DEPUY IRELAND - 3015516266 GLOBAL UNITE REVERSE TRAY 1; INSTRUMENT CASES

Catalog Number	210009013
Medical Device Problem Codes	Peeled/Delaminated (1454); Contamination /Decontamination Problem (2895)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	03/14/2024
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that instrument trays were damaged and flaking.
Additional Manufacturer Narrative
Product complaint # (b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803 (and/or part 4, as applicable).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, or its employees that the report constitutes an admission that the product, depuy synthes, 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.
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.
Additional Manufacturer Narrative
Product complaint # (b)(4).Investigation summary: according to the information received, ¿it was reported that instrument trays were damaged and flaking.Hospital is deeming them contaminated for procedures¿.The product was returned to depuy synthes for evaluation.The depuy synthes team conducted a visual inspection of the returned device.It is worth mentioning that the lid of the instrument case was not returned.Visual analysis of the returned sample revealed that global unite reverse tray 1 has the plastic coating of the brackets peeling off, causing difficulties during the sterilization process of the case.Additionally, signs of deformation were observed on seven (7) brackets.The overall appearance of the device exhibits evidence of constant use, servicing and repetitive sterilization cycles for over 7 years.The observed bent condition of the brackets was consistent with a random component failure that may have been caused by exposure to unintended forces and rough handling such as being dropped on the floor or being impacted with other devices.The overall complaint was confirmed as the observed condition of the global unite reverse tray 1 would contribute to the complained device issue.Based on the investigation findings, it has been determined that no corrective and/or preventative action is proposed.There is no indication that a design or manufacturing issue has caused the reported complaint condition.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.Device history lot: the product investigation found no evidence suspecting an error in the manufacturing or material that would be a contributing factor in the reported allegation(s).A manufacturing records evaluation (mre) was not performed.
Additional Manufacturer Narrative
Product complaint # (b)(4).Investigation summary: according to the information received, ¿it was reported that instrument trays were damaged and flaking.Hospital is deeming them contaminated for procedures¿.The product was returned to depuy synthese for evaluation.The depuy synthese team conducted a visual inspection of the returned device.It is worth mentioning that the lid of the instrument case was not returned.Visual analysis of the returned sample revealed that global unite reverse tray 1 has the plastic coating of the brackets peeling off, causing difficulties during the sterilization process of the case.Additionally, signs of deformation were observed on seven (7) brackets.The overall appearance of the device exhibits evidence of constant use, servicing and repetitive sterilization cycles for over 7 years.The observed bent condition of the brackets was consistent with a random component failure that may have been caused by exposure to unintended forces and rough handling such as being dropped on the floor or being impacted with other devices.The overall complaint was confirmed as the observed condition of the global unite reverse tray 1 would contribute to the complained device issue.Based on the investigation findings, it has been determined that no corrective and/or preventative action is proposed.There is no indication that a design or manufacturing issue has caused the reported complaint condition.As part of depuy synthese quality process, all devices are manufactured, inspected, and released to approved specifications.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.Device history lot: the product investigation found no evidence suspecting an error in the manufacturing or material that would be a contributing factor in the reported allegation(s).A manufacturing records evaluation (mre) was not performed.
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.

• Brand Name: GLOBAL UNITE REVERSE TRAY 1
• Common Device Name: INSTRUMENT CASES
• Manufacturer (Section D): DEPUY IRELAND - 3015516266; loughbeg ringaskiddy co.; cork ; EI
• Manufacturer (Section G): DEPUY ORTHOPAEDICS, INC. 1818910; 700 orthopaedic dr.; warsaw IN 46581 0988
• Manufacturer Contact: kate karberg ; 700 orthopaedic dr.; warsaw, IN 46581 ; 3035526892
• MDR Report Key: 18920978
• Report Number: 1818910-2024-05948
• Device Sequence Number: 6410594
• Product Code: FSM
• UDI-Device Identifier: 10603295451723
• UDI-Public: (01)10603295451723(10)PG2581711
• Combination Product (Y/N): N
• Initial Reporter State: KY
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup,Followup,Followup,Followup
• Report Date (Section B): 03/18/2024

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 Number: 210009013
• Device Lot Number: PG2581711
• 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: 03/14/2024
• Supplement Date Received by Manufacturer: 04/29/2024; 05/06/2024; 08/05/2024; 11/18/2024
• Initial Report FDA Received Date: 03/18/2024
• Supplement Report FDA Received Date: 04/30/2024; 05/08/2024; 08/06/2024; 11/19/2024
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 12/14/2017
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Unknown
• Patient Sequence Number: 1
• Patient Sex: Unknown