MAUDE Adverse Event Report: SMITH & NEPHEW, INC. BLADE,4.0 ELITE ABRADER 6/BX; SAW, POWERED, AND ACCESSORIES

Model Number	72200722
Health Effect - Clinical Codes	No Known Impact Or Consequence To Patient (2692); Test Result (2695)
Date of Event	12/29/2017
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that the device shed metal shavings, all were removed from the patient.No significant delay or patient injury reported.
Additional Manufacturer Narrative
Examination was not possible, as the device has not been returned.The investigation could not draw any conclusions about the reported event without the return of the device.

• Brand Name: BLADE,4.0 ELITE ABRADER 6/BX
• Common Device Name: SAW, POWERED, AND ACCESSORIES
• Manufacturer (Section D): SMITH & NEPHEW, INC.; 130 forbes boulevard; mansfield MA 02048
• MDR Report Key: 7181796
• Report Number: 1643264-2018-00037
• Device Sequence Number: 1274497
• Product Code: HAB
• UDI-Device Identifier: 03596010578006
• UDI-Public: (01)03596010578006(17)220512(10)50664175
• Combination Product (Y/N): N
• Initial Reporter State: NC
• Initial Reporter Country: US
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: company representative,health
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 02/13/2018

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 Expiration Date: 05/12/2022
• Device Model Number: 72200722
• Device Catalogue Number: 72200722
• Device Lot Number: 50664175
• Was Device Available for Evaluation?: No
• Initial Date Received by Manufacturer: 12/29/2017
• Supplement Date Received by Manufacturer: 02/07/2018
• Initial Report FDA Received Date: 01/11/2018
• Supplement Report FDA Received Date: 02/13/2018
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1