SURGICAL SIMPLEX P

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1991-12-31 for SURGICAL SIMPLEX P manufactured by Howmedica.

Event Text Entries

[46] During repair fractured hip, patient became hypotensive at time of application of bone cement, methyl methacrylate. Post -operative head cat scan revealed large infarct cerebellum. Patient expired the following day. Know adverse reaction of methyl methacrylate include: cerebrovascular accident, myocardial infarction, cardiac arrest, sudden deathdevice labeled for single use. Patient medical status prior to event: satisfactory condition. There was not multiple patient involvement. Invalid data - on device service/maintenance. No data - regarding date last serviced. Service provided by: invalid data. Invalid data - service records availability. No imminent hazard to public health claimed. Device used as labeled/intended. Device was not evaluated after the event. Method of evaluation: no data. Results of evaluation: no data. Conclusion: no data. Certainty of device as cause of or contributor to event: invalid data. Corrective actions: invalid data. The device was destroyed/disposed of.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number132
MDR Report Key132
Date Received1991-12-31
Date of Report1991-12-19
Date of Event1991-12-13
Date Facility Aware1991-12-13
Report Date1991-12-19
Date Reported to FDA1991-12-19
Date Reported to Mfgr1991-12-19
Date Added to Maude1992-03-30
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameSURGICAL SIMPLEX P
Generic NameMETHYL METHACRYLATE
Product CodeJXH
Date Received1991-12-31
Lot NumberUNKNOWN
ID NumberUNKNOWN
OperatorOTHER HEALTH CARE PROFESSIONAL
Device AvailabilityN
Implant FlagY
Device Sequence No1
Device Event Key130
ManufacturerHOWMEDICA


Patients

Patient NumberTreatmentOutcomeDate
101. Death 1991-12-31

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