MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06,07 report with the FDA on 2002-05-24 for RASP HANDLE STYLE A 31-473610 manufactured by Biomet, Inc..
[247566]
Immediately following hip arthroplasty procedure in 2002, radiographs revealed a piece of coiled metal at surgical site. Pt was returned to surgery to remove fragment suspected to be a piece of the handle release mechanism.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 1825034-2002-00052 |
MDR Report Key | 402039 |
Report Source | 06,07 |
Date Received | 2002-05-24 |
Date of Report | 2002-05-22 |
Date of Event | 2002-04-13 |
Report Date | 2002-05-23 |
Date Mfgr Received | 2002-04-25 |
Device Manufacturer Date | 1987-01-01 |
Date Added to Maude | 2002-07-01 |
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 | 3 |
Event Location | 3 |
Manufacturer Contact | BETH ALBERT, AST. |
Manufacturer Street | P.O. BOX 587 |
Manufacturer City | WARSAW IN 465810587 |
Manufacturer Country | US |
Manufacturer Postal | 465810587 |
Manufacturer Phone | 5742676639 |
Manufacturer G1 | * |
Manufacturer Street | * |
Manufacturer City | * |
Manufacturer Country | * |
Single Use | 3 |
Previous Use Code | 3 |
Removal Correction Number | NA |
Event Type | 3 |
Type of Report | 3 |
Brand Name | RASP HANDLE STYLE A |
Generic Name | INSTRUMENT |
Product Code | GAC |
Date Received | 2002-05-24 |
Returned To Mfg | 2002-04-25 |
Model Number | NA |
Catalog Number | 31-473610 |
Lot Number | 498080 |
ID Number | NA |
Operator | HEALTH PROFESSIONAL |
Device Availability | R |
Device Eval'ed by Mfgr | Y |
Implant Flag | N |
Date Removed | A |
Device Sequence No | 1 |
Device Event Key | 391057 |
Manufacturer | BIOMET, INC. |
Manufacturer Address | P.O. BOX 587 WARSAW IN 465810587 US |
Baseline Brand Name | RASP HANDLE STYLE A |
Baseline Generic Name | INSTRUMENT |
Baseline Model No | NA |
Baseline Catalog No | 31-473610 |
Baseline ID | NA |
Baseline Device Family | RASP HANDLE STYLE A |
Baseline Shelf Life [Months] | NA |
Baseline PMA Flag | N |
Baseline 510K PMN | N |
Baseline Preamendment | N |
Baseline Transitional | N |
510k Exempt | Y |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2002-05-24 |