MAUDE Adverse Event Report: CONMED CORPORATION FRAZIER INSTR 12 FRENCH, 50/C; SURGICAL INSTRUMENTS, STERILE

Model Number	0033120
Medical Device Problem Code	Tear, Rip or Hole in Device Packaging (2385)
Health Effect - Clinical Code	No Patient Involvement (2645)
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The reported unused device was returned for evaluation in its original unopened package.Label verification and visual inspection were performed.A hole was found in the poly material, adjacent to the device's distal obturator, of the package.This defect resulted in a sterile breach and was likely caused by the device after the sealing process.The manufacturing documents from the device history record have been reviewed with special attention to the manufacturing and inspection of this product.The products released for distribution were found to have met all specifications prior to shipment.Of the lot containing (b)(4) units, no prior complaints have been received.A two-year review of complaint history revealed (b)(4) similar complaints, with (b)(4) devices, for this device family and failure mode.During this same time frame, (b)(4) devices have been manufactured and shipped worldwide, making the rate of occurrence of this (b)(4) percent.This reported packaging issue was obvious to the distributor, prompting the return of the device for evaluation.There was no patient involvement.As with all medical devices, examination of the product occurs multiple times prior to use.Good clinical practice would include examination and verification of the original packaging and its labeling to ensure both are intact.This issue will continue to be monitored through the complaint system to assure patient safety.
Event or Problem Description
The distributor in (b)(6) reported a "scratch" on the sterile pouch of device.There was no patient involvement as this defect was discovered during incoming inspection.This report is raised on the basis of a sterility breach found during the device evaluation.

• Brand Name: FRAZIER INSTR 12 FRENCH, 50/C
• Common Device Name: SURGICAL INSTRUMENTS, STERILE
• Manufacturer (Section D): CONMED CORPORATION; 525 french road; utica NY 13502
• MDR Report Key: 7374888
• Report Number: 1320894-2018-00067
• Device Sequence Number: 2024239
• Product Code: GCX
• UDI-Device Identifier: 30653405000147
• UDI-Public: (01)30653405000147(17)210925(10)201609261
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: distributor,foreign,other
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 03/27/2018

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: No Information
• Device Expiration Date: 09/25/2021
• Device Model Number: 0033120
• Device Catalogue Number: 0033120
• Device Lot Number: 201609261
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 08/08/2017
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 02/27/2018
• Initial Report FDA Received Date: 03/27/2018
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1