inforMED
MalfunctionHTE

PERIOSTEAL ELEVATOR 14MM STRAIGHT BLADE-ROUND EDGE

Received Oct 15, 2019 · Event occurred Sep 18, 2019

Report 2939274-2019-61545 · MDR key 9191798

Device

Generic name

Elevator

Model number

399.37

Catalog number

399.37

Product problems

  • Break
  • Break

Patient

Not reported

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

DEVICE USED IN A VETERINARY CASE ¿ NO PATIENT INFORMATION WILL BE REPORTED. COMPLAINANT PART IS EXPECTED TO BE RETURNED FOR MANUFACTURER REVIEW/INVESTIGATION, BUT HAS YET TO BE RECEIVED. WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. PRODUCT WAS NOT RETURNED. BASED ON THE INFORMATION AVAILABLE, IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND/OR PREVENTATIVE ACTION IS PROPOSED. THIS COMPLAINT WILL BE ACCOUNTED FOR AND MONITORED VIA POST MARKET SURVEILLANCE ACTIVITIES. IF ADDITIONAL INFORMATION IS MADE AVAILABLE, THE INVESTIGATION WILL BE UPDATED AS APPLICABLE. 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.

Description of Event or Problem

VETERINARY COMPLAINT: IT WAS REPORTED THAT DURING A PROCEDURE ON (B)(6) 2019, THE PERIOSTEAL ELEVATOR STRAIGHT BLADE SNAPPED IN TWO, ALMOST IN THE MIDLINE, AT THE HANDLE. THE PROCEDURE WAS COMPLETED SUCCESSFULLY WITH A FIVE (5) MINUTE DELAY. PATIENT WAS FINE. THIS REPORT IS FOR A PERIOSTEAL ELEVATOR. THIS IS REPORT 1 OF 1 FOR (B)(4).

Additional Manufacturer Narrative

THE PERIOSTEAL ELEVATOR 14 MM STRAIGHT BLADE-ROUND EDGE (PART # 399.37, LOT # A7NA40, MFG # WEEK 40, 2004) WAS RECEIVED AT US (B)(4) WITH THE HANDLE BROKEN TRANSVERSELY INTO 2 SEPARATE PIECES. THIS IS CONSISTENT WITH THE REPORTED COMPLAINT CONDITION, THUS CONFIRMING THE COMPLAINT. THE METALLIC PORTION OF THE INSTRUMENT SHOWED NO SIGNS OF BREAKAGE. DIMENSIONAL ANALYSIS WAS NOT PERFORMED DUE TO POST MANUFACTURING DAMAGE. THERE IS NO INDICATION THAT A DESIGN OR MANUFACTURING ISSUE CONTRIBUTED TO THE COMPLAINT. WHILE NO DEFINITIVE ROOT CAUSE COULD BE DETERMINED IT IS POSSIBLE THAT THE DEVICE ENCOUNTERED UNINTENDED FORCES. NO NEW MALFUNCTIONS WERE OBSERVED DURING THE COURSE OF THIS INVESTIGATION. ADDITIONAL MONITORING FOR ANY POTENTIAL SAFETY SIGNALS WILL BE CONDUCTED THROUGH COMPLAINT TRENDING AND OTHER POST MARKET SAFETY SURVEILLANCE ACTIVITIES. BASED ON THE INVESTIGATION FINDINGS, IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND/OR PREVENTATIVE ACTION IS PROPOSED. DEVICE HISTORY LOT: PART NUMBER: 399.37, LOT NUMBER: A7NA40, MANUFACTURING SITE: (B)(4). RELEASE TO WAREHOUSE DATE: WEEK 40, 2004. A REVIEW OF THE DEVICE HISTORY RECORDS IS NOT POSSIBLE, THE DHR IS NO LONGER AVAILABLE DUE TO THE AGE OF THE INSTRUMENT (OVER 15 YEARS OLD). 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.