inforMED
MalfunctionJXH

PRM STM INSRTR EXTRCT

Received Nov 30, 2022 · Event occurred Apr 4, 2022

Report 1038671-2022-01533 · MDR key 15885310

Device

Generic name

Orthopedic Manual Surgical Instrument

Manufacturer

Exactech, Inc.

Model number

301-07-10

Catalog number

301-07-10

Lot number

72726013

Product problems

  • Break
  • Break

Patient

Unknown

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

PENDING EVALUATION.

Description of Event or Problem

IT WAS REPORTED THAT THIS INSTRUMENT COULD HAVE BROKEN DURING SURGERY. HOWEVER, THE BREAKAGE HAS BEEN NOTICED AT THE RECOVERY OF THE INSTRUMENTATION-SET BY OUR LOGISTICS DEPT., AFTER THE CLEANING REALIZED BY THE STERILIZATION TEAM OF THE HOSPITAL. NO INFORMATION HAS BEEN RECEIVED FROM THE HOSPITAL REGARDING THIS ISSUE AND XNOV IP DIDN'T RECEIVE ANY REQUEST FOR COMPLEMENTARY INFORMATION REGARDING THIS ISSUE AS WELL.

Additional Manufacturer Narrative

SECTION H10: (H3) THE MOSTLY LIKELY UNDERLYING CAUSE FOR THE BROKEN INSTRUMENT REPORTED CANNOT BE DETERMINED AS THE DEVICE APPEARS TO FUNCTION AS INTENDED. SECTION H11: *THE FOLLOWING SECTIONS HAVE CORRECTED INFORMATION: (H6) COMPONENT CODE: 4755, PART/COMPONENT/SUB-ASSEMBLY TERM NOT APPLICABLE