MAUDE Adverse Event Report: TORNIER INC TORNIER PERFORM REVERSED GLENOID CENTRL SCREW DRILL GDE6.5MM; GUIDE, SURGICAL, INSTRUMENT

Catalog Number	MWJ114
Medical Device Problem Code	Failure to Clean Adequately (4048)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	12/19/2024
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Once the investigation has been completed any additional information will be reported in a supplemental report.
Event or Problem Description
Tornier perform reverse glenoid instrument tray.The instrument should be cleaned and disinfected before delivery.Vendor claimed that inspection check for instrument was done by their staff.However, upon checking, ssu staff found that the lumen of central screw drill guide was impacted with dry blood & tissue.The dry blood and tissue were removed from the instrument.The sales representative claimed that the instrument were previously used by ahnh.
Additional Manufacturer Narrative
Correction - d9 product available to stryker.The reported event could not be confirmed, since the device was not returned for evaluation and no other evidence were provided.The device inspection was not possible as the product was not returned for investigation.A review of the device history for the reported lot did not indicate any abnormalities.No corrective actions are required at this time.A review of the labeling did not indicate any abnormalities.No indications of material, manufacturing or design related problems were found during the investigation.More detailed information about the complaint event as well as the affected device must be available in order to determine the root cause of the complaint event.If the device is returned or if any additional information is provided, the investigation will be reassessed.
Event or Problem Description
Tornier perform reverse glenoid instrument tray.The instrument should be cleaned and disinfected before delivery.Vendor claimed that inspection check for instrument was done by their staff.However, upon checking, ssu staff found that the lumen of central screw drill guide was impacted with dry blood & tissue.The dry blood and tissue were removed from the instrument.The sales representative claimed that the instrument were previously used by ahnh.

• Brand Name: TORNIER PERFORM REVERSED GLENOID CENTRL SCREW DRILL GDE6.5MM
• Common Device Name: GUIDE, SURGICAL, INSTRUMENT
• Manufacturer (Section D): TORNIER INC; 10801 nesbitt avenue s; bloomington MN 55437
• Manufacturer (Section G): TORNIER INC; 10801 nesbitt avenue s; bloomington MN 55437
• Manufacturer Contact: anna jusinski ; 325 corporate drive; mahwah, NJ 07430 ; 2018315000
• MDR Report Key: 21231166
• Report Number: 0001649390-2025-00042
• Device Sequence Number: 20983175
• Product Code: FZX
• UDI-Device Identifier: 00846832062379
• UDI-Public: (01)00846832062379(11)210302(10)CV0223015
• Combination Product (Y/N): N
• Initial Reporter Country: HK
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: User Facility
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date (Section B): 03/12/2025

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: MWJ114
• Device Lot Number: CV0223015
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 12/27/2024
• Supplement Date Received by Manufacturer: 02/14/2025
• Initial Report FDA Received Date: 01/24/2025
• Supplement Report FDA Received Date: 03/12/2025
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 03/02/2021
• 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: Reuse
• Patient Sequence Number: 1
• Patient Sex: Unknown