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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITH & NEPHEW, INC. FOOTSWITCH,EP-1,PEDAL STYLE,; ARTHROSCOPE

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SMITH & NEPHEW, INC. FOOTSWITCH,EP-1,PEDAL STYLE,; ARTHROSCOPE Back to Search Results
Model Number 7205396S
Health Effect - Clinical Code No Known Impact Or Consequence To Patient (2692)
Date of Event 05/18/2018
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the left pedal is sticky, causing the shaver to run continuously.No patient injury reported.
 
Additional Manufacturer Narrative
There was a relationship found between the returned device and the reported incident.A visual inspection was performed on the product and housing was scratched.Complaint of sticky reverse (left) was confirmed.Footswitch failed functional testing using a known good control unit and mdu.The actuator for the reverse pedal is sticking from corrosion buildup and sticks when depressed.The complaint investigation has concluded that the device has exceeded its recommended service life limit and has succumbed to expected wear and tear.A review of the device history records showed there were no indications to suggest that the product did not meet manufacturing specification or would not be able to perform as intended.
 
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Brand Name
FOOTSWITCH,EP-1,PEDAL STYLE,
Common Device Name
ARTHROSCOPE
Manufacturer (Section D)
SMITH & NEPHEW, INC.
76 s. meridian ave.
oklahoma city OK 73107 6512
MDR Report Key7535256
Report Number1643264-2018-00396
Device Sequence Number11206308
Product Code HRX
UDI-Device Identifier03596010251978
UDI-Public(01)03596010251978
Combination Product (Y/N)N
Initial Reporter StateAL
Initial Reporter CountryUS
PMA/510(K) Number
K892062
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source company representative,health
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 07/02/2018
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 Model Number7205396S
Device Catalogue Number7205396
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/07/2018
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/18/2018
Supplement Date Received by Manufacturer07/10/2018
Initial Report FDA Received Date05/22/2018
Supplement Report FDA Received Date07/12/2018
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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