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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES BRANDYWINE BUTTRESS/COMPRESSION NUT FOR 357.369; TRACTION, APPARATUS, NON-POWERED

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SYNTHES BRANDYWINE BUTTRESS/COMPRESSION NUT FOR 357.369; TRACTION, APPARATUS, NON-POWERED Back to Search Results
Catalog Number 357.371
Device Problem Failure to Align (2522)
Patient Problem No Patient Involvement (2645)
Event Type  malfunction  
Manufacturer Narrative
No patient involvement reported.Date of event is unknown.Device is an instrument and is not implanted / explanted.Device history records review was completed for part# 357.371, lot# 4436455.Supplier: (b)(6), release to warehouse date: (b)(6) 2002.Review of the device history records showed that there were no issues during the manufacture of the product that would contribute to this complaint condition.The device was received and the product evaluation is in progress.No conclusion can be drawn.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 Description
It was reported that during a routine maintenance check the sales consultant tried to put the guide sleeve and the buttress nut into the aiming arm but it didn't work.He then tried another sleeve and nut and they both went in without issue.The sales consultant could not determine whether the guide sleeve or the buttress nut was the issue.There was no case or patient involvement reported.This report is for one (1) buttress/compression nut for 357.369.This is report 2 of 2 for (b)(4).
 
Manufacturer Narrative
Device was used for treatment, not diagnosis.No therapy date.A product development investigation was performed for the guide sleeve (part 357.369, lot 4436176) and the buttress nut (part 357.371, lot 4436455) the subject device was returned with the complaint condition stating the returned instruments were tested with a known good mating aiming arm and the complaint condition could not be replicated.The devices were able to be inserted and removed from the aiming arm as intended without difficulty.The complaint condition cannot be confirmed therefore a root cause cannot be determined.A visual inspection, functional test, and a drawing review were performed as part of this investigation.As the complaint is unconfirmed, complaint history review and risk assessment review is not applicable for the investigation.Relevant product drawings were reviewed: the returned parts were determined to be suitable for the intended use when employed and maintained as recommended.A device history review was performed for the returned instruments¿ lot numbers and in each instance no mrrs, non-conformance records or complaint-related issues were identified with the lots numbers which may have contributed to the complaint condition.Mrr 40464 was written to address (b)(4) pieces out of (b)(4) pieces that did not show clarity in the etching of the device.All (b)(4) pieces were reworked and released.This mrr is not relevant to this complaint condition.No root cause could be determined as the complaint was not confirmed.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
 
Event Description
Update: concomitant device reported: aiming arm (part number unknown, lot number unknown, quantity 1).
 
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Brand Name
BUTTRESS/COMPRESSION NUT FOR 357.369
Type of Device
TRACTION, APPARATUS, NON-POWERED
Manufacturer (Section D)
SYNTHES BRANDYWINE
1303 goshen parkway
west chester PA 19380
Manufacturer (Section G)
SYNTHES BRANDYWINE
1303 goshen parkway
west chester PA 19380
Manufacturer Contact
michael cote
1302 wrights lane east
west chester, PA 19380
6107195000
MDR Report Key6300019
MDR Text Key66465753
Report Number2530088-2017-10036
Device Sequence Number1
Product Code HST
UDI-Device Identifier10886982196057
UDI-Public(01)10886982196057(10)4436455
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 03/07/2017
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/03/2017
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number357.371
Device Lot Number4436455
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/19/2017
Is the Reporter a Health Professional? Yes
Date Manufacturer Received03/07/2017
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured11/05/2002
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
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