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U.S. Department of Health and Human Services

Class 2 Device Recall DeRoyal CHILDREN'S ORTHOPEDIC TRACEPACK

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 Class 2 Device Recall DeRoyal CHILDREN'S ORTHOPEDIC TRACEPACKsee related information
Date Initiated by FirmOctober 03, 2024
Date PostedNovember 05, 2024
Recall Status1 Open3, Classified
Recall NumberZ-0308-2025
Recall Event ID 95509
510(K)NumberK842648 
Product Classification General surgery tray - Product Code LRO
ProductDeRoyal CHILDREN'S ORTHOPEDIC TRACEPACK, 89-9349-06
Code Information UDI/ DI 00749756917292 (each), 50749756917297 (case): Lot Numbers: lot 58828011 exp 11/1/2024; lot 59098364 exp 1/1/2026; lot 59259658 exp 7/1/2025; lot 59839687 exp 11/1/2025
Recalling Firm/
Manufacturer		 DeRoyal Industries Inc
200 Debusk Ln
Powell TN 37849-4703
For Additional Information ContactTheresa Marsee
865-362-6465
Manufacturer Reason
for Recall		DeRoyal is recalling certain lots of surgical procedure pack products that contain a Stryker SafeAir Smoke Evacuation Pencil. The recall is due to Stryker receiving reports that the pencil is activating without manual input when plugged into a power source or remains active after buttons are released.
FDA Determined
Cause 2		Under Investigation by firm
ActionDeRoyal issued an URGENT! DEROYAL RECALL NOTICE to its consignees on 10/03/2024 via email. The notice explained the issue, potential risk, and requested the return of the affected packs. If the affected product was further distributed, the notice directed the distributor to notify its customers. This may be achieved directly by forwarding the recall notification and notify DeRoyal that you have done so, or the distributor may provide DeRoyal with your customer listing allowing them to contact your customers.
Quantity in Commerce384 units
DistributionUS Nationwide distribution in the state of OH.
Total Product Life CycleTPLC Device Report
1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
3 The manufacturer has initiated the recall and not all products have been corrected or removed. This record will be updated as the status changes.
510(K) Database510(K)s with Product Code = LRO
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