MAUDE Adverse Event Report: SMITH & NEPHEW, INC. HUMERAL SMALL HAMMER; ROD, FIXATION, INTRAMEDULLARY AND ACCESSORIES

Catalog Number	71751135
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	04/11/2024
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
H10: internal complaint reference (b)(4).
Event or Problem Description
It was reported that during an internal fixation surgery, the humeral small hammer fragmented when the nail was being impacted.The procedure was resumed, without any delay, using a competitors device.Even though it is unknown if broken pieces fell into the patient, no injury was reported as consequence of this problem.
Additional Manufacturer Narrative
H11- corrected data.B5- describe event or problem.H6- evaluation codes.
Event or Problem Description
It was reported that during an internal fixation surgery, the humeral small hammer fragmented when the nail was being impacted.No pieces fell inside the patient and no injury was reported as consequence of this problem.The procedure was resumed, without any delay, using a competitor's device.
Additional Manufacturer Narrative
H3, h6: the device was not returned for evaluation; therefore, a device analysis could not be performed.The clinical/medical investigation concluded that, per complaint details, it was noticed during a total knee arthroplasty that the hammer fragmented during an internal fixation surgery.Reportedly, no pieces fell inside the patient and the procedure was resumed using a competitor device without delay.As of the date of this medical investigation, the requested clinical documentation has not been provided and no clinical root cause can be concluded to have contributed to the reported event.Reportedly the patient was not injured as a consequence of this problem.Device batch number was not provided, thus, an evaluation of the manufacturing records could not be performed.A review of complaint history for the previous 12 months did not reveal similar events for the listed device.A review of the risk management file revealed this failure mode was previously identified.The anticipated risk level is still adequate.A historical review concluded that there are no prior actions related to this product and event.At this time, we have no evidence to conclude that the product failed to meet any specifications at the time of manufacture.This device is a reusable instrument that can be exposed to numerous surgeries.Damage from prolonged use, misuse or rough handling are likely potential factors that could contribute to the reported event.We recommend that all reusable instruments be routinely inspected for wear and damage and replaced as necessary.Based on this investigation, the need for corrective action is not indicated.Should the device or additional information be received, the complaint will be reopened.No further investigation is warranted for this complaint; however, we will continue to monitor for future complaints and investigate as necessary.We consider this investigation closed.

• Brand Name: HUMERAL SMALL HAMMER
• Common Device Name: ROD, FIXATION, INTRAMEDULLARY AND ACCESSORIES
• Manufacturer (Section D): SMITH & NEPHEW, INC.; 1450 brooks rd.; memphis TN 38116
• Manufacturer (Section G): SMITH & NEPHEW, INC.; 1450 brooks rd.; memphis TN 38116
• Manufacturer Contact: holly topping ; 7000 west william cannon drive; austin, TX 78735 ; 5123913905
• MDR Report Key: 19264850
• Report Number: 1020279-2024-00898
• Device Sequence Number: 2685643
• Product Code: HSB
• UDI-Device Identifier: 03596010515469
• UDI-Public: 03596010515469
• Combination Product (Y/N): N
• Initial Reporter Country: CO
• PMA/510(K) Number: K122170
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other,Foreign,Health Professional,Company Representative
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 06/17/2024

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: 71751135
• Device Lot Number: UNKNOWN
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 04/11/2024
• Supplement Date Received by Manufacturer: 06/10/2024; 06/14/2024
• Initial Report FDA Received Date: 05/07/2024
• Supplement Report FDA Received Date: 06/12/2024; 06/17/2024
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• 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 Age: 30 YR
• Patient Sex: Male