BENDING PLIERS FOR 3.5MM CLAVICLE PLATES/227MM LENGTH 329.291

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2015-12-21 for BENDING PLIERS FOR 3.5MM CLAVICLE PLATES/227MM LENGTH 329.291 manufactured by Synthes Tuttlingen.

Event Text Entries

[34018202] Additional narrative: event date: unknown. Device is an instrument and is not implanted/explanted. The device was received, the investigation could not be completed, and no conclusion could be drawn, as product is entering the complaint system. Device was used for treatment, not diagnosis. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[34018203] It was reported that during a routine field equipment inspection of a modular clavicle set, it was discovered that the screw was missing on the bottom of the pliers. There was no procedure or patient involvement. This is report 1 of 1 for (b)(4).
Patient Sequence No: 1, Text Type: D, B5


[35760548] Device history records was conducted. The report indicates that the: manufacturing date: jan 29th, 2010 part#: 329. 291, lot#: t943130, review of the device history records showed that there were no issues at the time of manufacturing of this device that would contribute to the issue outlined in this complaint. The photo and the complaint description show that the screw is missing but the threads were checked at the final inspection of the device on 29th january 2010 and found to be conforming. Device was used for treatment, not diagnosis. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[37125076] Product investigation summary: the complaint condition for the bending pliers (part 329. 291 / lot t943130) was likely caused by the tightening screw being lost upon disassembly in sterile processing; however, this complaint is not likely a result of any design related deficiency. The bending pliers are an instrument routinely used in the 3. 5mm lcp superior anterior clavicle plates system. The device was returned and reported to have been found without the screw in the bottom handle of the pliers. This condition is confirmed as the tightening screw was not returned with the device. It is likely that the screw was lost upon disassembly during sterile processing leading to this complaint condition. The device was manufactured in january, 2010 and is six (6) years old. The balance of the returned device is in fair working condition consistent with six (6) years of use. The associated drawing number was reviewed and determined to be suitable for the intended design, application, and dimensional conformity when used as recommended. The condition of the returned device does agree with the complaint description. Whether the complaint condition for this device can be replicated is not applicable for this condition. No non-conformance reports were generated during the production of this device. The complainant part was actually received by the manufacturer for evaluation on december 18, 2015. Field updated with new date of receipt. Device used for treatment, not diagnosis. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9680938-2015-10130
MDR Report Key5315362
Report SourceCOMPANY REPRESENTATIVE
Date Received2015-12-21
Date of Report2015-12-04
Date Mfgr Received2016-01-19
Device Manufacturer Date2010-01-29
Date Added to Maude2015-12-21
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactLINDA PLEWS
Manufacturer Street1302 WRIGHTS LANE EAST
Manufacturer CityWEST CHESTER PA 19380
Manufacturer CountryUS
Manufacturer Postal19380
Manufacturer Phone6107195000
Manufacturer G1SYNTHES TUTTLINGEN
Manufacturer StreetUNTER HASSLEN 5
Manufacturer CityTUTTLINGEN 78532
Manufacturer CountryGM
Manufacturer Postal Code78532
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBENDING PLIERS FOR 3.5MM CLAVICLE PLATES/227MM LENGTH
Generic NameINSTR, BENDING OR CONTOURING
Product CodeHXP
Date Received2015-12-21
Returned To Mfg2015-12-18
Catalog Number329.291
Lot NumberT943130
ID Number(01)10886982191946(10)T943130
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerSYNTHES TUTTLINGEN
Manufacturer AddressUNTER HASSLEN 5 TUTTLINGEN 78532 GM 78532


Patients

Patient NumberTreatmentOutcomeDate
10 2015-12-21

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