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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ASPEN SURGICAL PRODUCTS, CALEDONIA BARD-PARKER CARBON RIB-BACK BLADES SIZE 10, STERILE; BARD-PARKER BLADE

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ASPEN SURGICAL PRODUCTS, CALEDONIA BARD-PARKER CARBON RIB-BACK BLADES SIZE 10, STERILE; BARD-PARKER BLADE Back to Search Results
Model Number 371110-150
Device Problem Break (1069)
Patient Problem Foreign Body In Patient (2687)
Event Date 08/21/2018
Event Type  Injury  
Manufacturer Narrative
Aspen surgical received a medwatch letter from the fda (3401150000-2018-8013) indicating that a bard-parker blade broke while in use during a procedure.The incident occurred at the user facility.No sample was returned and no photographic evidence was available for evaluation.A manufacturing lot number was provided for review.No further information was provided regarding retrieval of broken blade.Three attempts were completed to obtain information from the end user with no response.A review of the device history record indicated no non-conformance's related to the reported issue.The most probable root cause could have been during the stamping or grinding process.Packaging process has established controls to mitigate broken or cracked blade condition, including a "medio" blade sensor that inspects 100% of packed pouches liner level prior to aluminum foil packaging.Also, excessive force applied by end user during surgery process could also cause blade condition.The following controls are in-place to mitigate "broken blade" condition at aspen surgical las piedras site: heat treatment in-process at the beginning and end of each lot are inspected for dimension integrity using a pin gauge, flatness gauge and perforation length gauge, ductility test, and hardness test.Heat treatment quality inspections at the beginning and end of each lot are inspected for dimension integrity using a pin gauge, flatness gauge and perforation length gauge, ductility test, and hardness test.No further information is available.Sample was not returned.However if sample becomes available and any additional relevant information is identified, the additional relevant information will be submitted in a supplemental report.Device not returned.
 
Event Description
Aspen surgical received a medwatch letter from the fda indicating that a bard-parker blade broke during a procedure.The incident occurred at the user facility.This report was filed in our complaint handling system as (b)(4).
 
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Brand Name
BARD-PARKER CARBON RIB-BACK BLADES SIZE 10, STERILE
Type of Device
BARD-PARKER BLADE
Manufacturer (Section D)
ASPEN SURGICAL PRODUCTS, CALEDONIA
6945 southbelt dr. s.e.
caledonia MI 49316
Manufacturer (Section G)
SAME AS ABOVE
Manufacturer Contact
jordan hackert
6945 southbelt dr. s.e.
caledonia, MI 49316
6165367508
MDR Report Key7886041
MDR Text Key120636014
Report Number1836161-2018-00097
Device Sequence Number1
Product Code GES
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional,user faci
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 08/21/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/18/2018
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Model Number371110-150
Device Lot Number0155124
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received08/21/2018
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured01/12/2018
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Other; Required Intervention;
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