MAUDE Adverse Event Report: DEPUY MITEK LLC US HEALIX TRANSTEND TI ANC W/OC; SOFT-TISSUE ANCHOR, BIOABSORBABLE

Catalog Number	222260
Medical Device Problem Code	Migration or Expulsion of Device (1395)
Health Effect - Clinical Code	No Consequences Or Impact To Patient (2199)
Date of Event	03/29/2013
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.Mitek complaints received only the inserter and not the anchor, suture or needle.We cannot confirm this complaint or discern a root cause for the reported failure.A batch record review has been conducted to determine if there were any internal processing issues which would have contributed to the nature of the product complaint.Our results indicate that this batch of product was processed without incident and therefore there is no internally assignable cause for the reported problem.Further, a review into the depuy mitek complaints system revealed one other dissimilar complaint for this lot of devices that were released to distribution.At this point, no further action is warranted.However, depuy mitek will continue to track any related complaints within this device family as a means of monitoring the extent with which this complaint is observed in the field.Udi: (b)(4).This report is being filed from the remetrex complaint management system as required under mitek's corrective and preventative actions (capa) to file usa fda mdr missed malfunctions.
Event or Problem Description
It was reported that the needle pulled out.No more details.They used another like device.

• Brand Name: HEALIX TRANSTEND TI ANC W/OC
• Common Device Name: SOFT-TISSUE ANCHOR, BIOABSORBABLE
• Manufacturer (Section D): DEPUY MITEK LLC US; 325 paramount drive; raynham MA 02767
• MDR Report Key: 7605434
• Report Number: 1221934-2018-50786
• Device Sequence Number: 2142008
• Product Code: HWC
• UDI-Device Identifier: 10886705008063
• UDI-Public: 10886705008063
• Combination Product (Y/N): N
• Initial Reporter Country: FR
• PMA/510(K) Number: K102298
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Initial Reporter Occupation: Health Professional
• Type of Report: Initial
• Report Date (Section B): 04/02/2013

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: 06/01/2015
• Device Catalogue Number: 222260
• Device Lot Number: 3620193
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 09/05/2013
• Initial Date Received by Manufacturer: 04/02/2013
• Initial Report FDA Received Date: 06/15/2018
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1