MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2008-06-30 for IV POST WITH CLAMP 18 3/4 00-1044-007-00 manufactured by Zimmer Orthopaedic Surgical Products.
[16407883]
Clamp on iv post was broken.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1035617-2008-00009 |
| MDR Report Key | 1069714 |
| Report Source | 05 |
| Date Received | 2008-06-30 |
| Date of Report | 2008-06-05 |
| Date of Event | 2008-04-29 |
| Date Facility Aware | 2008-04-29 |
| Report Date | 2008-06-05 |
| Date Reported to Mfgr | 2008-06-05 |
| Date Mfgr Received | 2008-06-05 |
| Date Added to Maude | 2009-07-21 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 3 |
| Manufacturer Contact | DEBARA REESE |
| Manufacturer Street | 200 WEST OHIO AVENUE |
| Manufacturer City | DOVER OH 44622 |
| Manufacturer Country | US |
| Manufacturer Postal | 44622 |
| Manufacturer Phone | 3303649483 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | IV POST WITH CLAMP 18 3/4 |
| Generic Name | IV POST WITH CLAMP |
| Product Code | ILZ |
| Date Received | 2008-06-30 |
| Returned To Mfg | 2008-06-05 |
| Catalog Number | 00-1044-007-00 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ZIMMER ORTHOPAEDIC SURGICAL PRODUCTS |
| Manufacturer Address | 2021 OLD MOUNTAIN ROAD STATESVILLE NC 28677 US 28677 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2008-06-30 |