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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH SIZE #7 4-IN-1 CUTTING BLOCK CAPTURED ASSY. TRIA. EXP. INSTR.; INSTRUMENT

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STRYKER ORTHOPAEDICS-MAHWAH SIZE #7 4-IN-1 CUTTING BLOCK CAPTURED ASSY. TRIA. EXP. INSTR.; INSTRUMENT Back to Search Results
Catalog Number 6541-1-707E
Device Problem Break (1069)
Patient Problem Device Embedded In Tissue or Plaque (3165)
Event Date 04/07/2015
Event Type  malfunction  
Event Description
The customer reported that during a triathlon primary knee operation, the femoral cutting block was removed and the attachment pin had allegedly broken off the cutting block and was left embedded in the bone.The pin was noticed and removed.A replacement device was not needed because the femoral cuts had already been made.
 
Manufacturer Narrative
When completed, the investigation results will be submitted in a supplemental report.
 
Manufacturer Narrative
An event regarding pin dissociation from a triathlon cutting guide was reported.The event was confirmed.Method & results: -device evaluation and results: inspection of the returned device confirmed the pin had dissociated from the device body.Additional dimensional inspection was not performed as it was confirmed the product was within scope of the associated capa.-medical records received and evaluation: not performed as there was no indication that patient factors contributed to the reported event.-device history review: all devices accepted into final stock conformed to specification.This review confirmed the device was manufactured prior to capa implementation.-complaint history review: there have been no similar reported events for the reported lot id.Conclusions: the investigation concluded that the fixation peg disassociating from the triathlon cutting block was caused by a manufacturing nonconformance.It was concluded that the supplier, (b)(4), had not performed the required press fit operation between the peg and block which led to the pin coming out of the assembly.Stryker reserves the right to re-evaluate this investigation if additional relevant information becomes available.
 
Event Description
The customer reported that during a triathlon primary knee operation, the femoral cutting block was removed and the attachment pin had allegedly broken off the cutting block and was left embedded in the bone.The pin was noticed and removed.A replacement device was not needed because the femoral cuts had already been made.
 
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Brand Name
SIZE #7 4-IN-1 CUTTING BLOCK CAPTURED ASSY. TRIA. EXP. INSTR.
Type of Device
INSTRUMENT
Manufacturer (Section D)
STRYKER ORTHOPAEDICS-MAHWAH
325 corporate drive
mahwah NJ 07430
Manufacturer (Section G)
STRYKER ORTHOPAEDICS-MAHWAH
325 corporate drive
mahwah NJ 07430
Manufacturer Contact
keyla navedo
325 corporate drive
mahwah, NJ 07430
2018315000
MDR Report Key4745723
MDR Text Key5774827
Report Number0002249697-2015-01432
Device Sequence Number1
Product Code MBH
Combination Product (y/n)N
Reporter Country CodeUK
PMA/PMN Number
K123486
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Health Professional,health professional,oth
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 04/09/2015
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
Device Operator Health Professional
Device Catalogue Number6541-1-707E
Device Lot NumberSB3M92
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/27/2015
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 04/09/2015
Initial Date FDA Received05/04/2015
Supplement Dates Manufacturer ReceivedNot provided
Supplement Dates FDA Received09/14/2015
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured12/03/2008
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
Patient Outcome(s) Other;
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