MAUDE Adverse Event Report: DEPUY IRELAND - 9616671 RECLAIM UNIVERSAL HEX DRIVER; RECLAIM INSTRUMENTS : HANDLES

Catalog Number	297531000
Medical Device Problem Code	Appropriate Device Problem Term/Code Not Available (3191)
Health Effect - Clinical Code	Not Applicable (3189)
Date of Event	03/17/2018
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Event or Problem Description
Also the t-handle/screw driver kept slipping and would not snap at the appropriate torque, it would just keep spinning.Surgical delay of 5 minutes and all pieces were retrieved.
Additional Manufacturer Narrative
Product complaint # pc-(b)(4).Investigation summary examination of the returned instrument confirmed the complaint.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.

• Brand Name: RECLAIM UNIVERSAL HEX DRIVER
• Common Device Name: RECLAIM INSTRUMENTS : HANDLES
• Manufacturer (Section D): DEPUY IRELAND - 9616671; loughbeg ringaskiddy co.; cork ; EI
• MDR Report Key: 7425068
• Report Number: 1818910-2018-57256
• Device Sequence Number: 1591645
• Product Code: HXX
• UDI-Device Identifier: 10603295156352
• UDI-Public: 10603295156352
• Combination Product (Y/N): N
• Initial Reporter State: TX
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: company representative,health
• Initial Reporter Occupation: Health Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 03/17/2018

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 Catalogue Number: 297531000
• Device Lot Number: J0311
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 04/17/2018
• Initial Date Received by Manufacturer: 03/17/2018
• Supplement Date Received by Manufacturer: 11/08/2018
• Initial Report FDA Received Date: 04/12/2018
• Supplement Report FDA Received Date: 11/15/2018
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Patient Age: 85 YR