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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH STERNAL ZIPFIX WITH NEEDLE STERILE/20 PACK; CERCLAGE, FIXATION

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SYNTHES GMBH STERNAL ZIPFIX WITH NEEDLE STERILE/20 PACK; CERCLAGE, FIXATION Back to Search Results
Catalog Number 08.501.001.20S
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/12/2024
Type of Reportable Event Malfunction
Additional 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: d9: complainant part is expected to be returned for manufacturer review/investigation, but has yet to be received.E3: initial reporter is a synthes employee.H3, h6: the investigation could not be completed; no conclusion could be drawn, as no product was received.Based on the information available, it has been determined that no corrective and/or 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 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 or Problem Description
Device report from china reports an event as follows: it was reported that on (b)(6) 2024 during surgery, the needle on the product in question detached.Another device was used to complete the surgery successfully with no surgical delay.There were no adverse patient consequences, no additional medical intervention was required.No further information is available to report.This report is for a sternal zipfix with needle sterile/20 pack.This is report 1 of 1 for (b)(4).
 
Additional 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.Additional narrative: investigation summary: the product was returned to depuy synthes for evaluation.The depuy synthes team conducted a visual inspection of the returned device.Visual analysis of the returned sample revealed that sternal zipfix cable tie w/needle peek 2 was received without the needle and the zipfix cable was observed broken.Only a section of the implant was received of evaluation.A dimensional inspection for the sternal zipfix cable tie w/needle peek 2 was not performed due to post manufacturing damage.The observed condition of the device was consistent with a random component failure that may have been caused by exposure to unintended forces.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.The overall complaint was confirmed as the observed condition of the sternal zipfix cable tie w/needle peek 2 would contribute to the complained device issue.There is no indication that a design or manufacturing issue has caused the complaint condition.Based on the investigation findings, it has been determined that 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.Drawing/specifications reviewed? reviewed dimensional inspection: n/a device history lot a manufacturing record evaluation was performed for the finished device part:08.501.001.20s lot: 1529p84 it was electronically reviewed and no nonconformances / manufacturing irregularities were identified during the manufacturing process.The product was released on: 08-nov-2022 manufacturing site:jabil bettlach expiry date:01-sep-2027 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
STERNAL ZIPFIX WITH NEEDLE STERILE/20 PACK
Common Device Name
CERCLAGE, FIXATION
Manufacturer (Section D)
SYNTHES GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
Manufacturer (Section G)
JABIL BETTLACH
muracherstrasse 3
monument CO 2544
SZ   2544
Manufacturer Contact
kate karberg
1302 wright lane east
west chester, PA 19380
3035526892
MDR Report Key18953813
Report Number8030965-2024-03948
Device Sequence Number7078521
Product Code JDQ
UDI-Device Identifier20887587025992
UDI-Public(01)20887587025992
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K110789
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
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 Number08.501.001.20S
Device Lot Number1529P84
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 03/07/2024
Supplement Date Received by Manufacturer04/29/2024
Initial Report FDA Received Date03/21/2024
Supplement Report FDA Received Date05/23/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/08/2022
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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