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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY ORTHOPAEDICS INC US CANAL REAMER 8MM BULLET TIP; HIP INSTRUMENT/TRIAL

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DEPUY ORTHOPAEDICS INC US CANAL REAMER 8MM BULLET TIP; HIP INSTRUMENT/TRIAL Back to Search Results
Catalog Number 200184080
Device Problem Misconnection (1399)
Patient Problems No Consequences Or Impact To Patient (2199); No Information (3190)
Event Date 10/17/2017
Event Type  malfunction  
Manufacturer Narrative
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 routine inspection, it was noticed that there was an issue with coupling.
 
Manufacturer Narrative
The instrument associated with this report was not returned.Depuy considers the investigation closed at this time.Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary.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
CANAL REAMER 8MM BULLET TIP
Type of Device
HIP INSTRUMENT/TRIAL
Manufacturer (Section D)
DEPUY ORTHOPAEDICS INC US
700 orthopaedic drive
warsaw IN 46581 0988
Manufacturer (Section G)
DEPUY ORTHOPAEDICS INC US
700 orthopaedic drive
warsaw IN 46581 0988
Manufacturer Contact
chad gibson
700 orthopaedic drive
warsaw, IN 46581-0988
5743725905
MDR Report Key7033056
MDR Text Key92079449
Report Number1818910-2017-28980
Device Sequence Number1
Product Code HTO
UDI-Device Identifier10603295080398
UDI-Public10603295080398
Combination Product (y/n)N
Reporter Country CodeCA
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Reporter Occupation Health Professional
Type of Report Initial,Followup
Report Date 10/17/2017
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 Number200184080
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 10/17/2017
Initial Date FDA Received11/15/2017
Supplement Dates Manufacturer Received09/05/2018
Supplement Dates FDA Received09/25/2018
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
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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