UNKNOWN COONRAD/MORREY HUMERAL ASSEMBLY

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2015-09-11 for UNKNOWN COONRAD/MORREY HUMERAL ASSEMBLY manufactured by Zimmer Inc.

Event Text Entries

[25546782] Information was received via published literature. (b)(4). Operative notes were requested however none provided. Relevant medical history and adherence to rehabilitation protocol are unknown. No devices or photos were received; therefore the condition of the components is unknown. The part and lot numbers of the product are unknown; therefore the device history records could not be reviewed. These products were used for treatment. The complaint history for these products could not be reviewed due to the lack of lot numbers. It could not be confirmed if the devices are an approved and compatible combination. Single-use, sterilized devices manufactured or distributed by zimmer are sterilized in accordance with fda regulations and iso standards to a sterility assurance level of 1. 0 x 10-6 or better. Therefore, it is highly unlikely that the specified device caused any patient infection. A definitive root cause cannot be determined with the information provided. The investigation could not verify or identify any evidence of product contribution to the reported problem. Please reference literature at the following location: http://www. Ncbi. Nlm. Nih. Gov/pubmed/25035841.
Patient Sequence No: 1, Text Type: N, H10


[25546783] It is reported that 2 patients were revised due to infection.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1822565-2015-01789
MDR Report Key5070656
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2015-09-11
Date of Report2015-08-20
Date Mfgr Received2015-08-20
Date Added to Maude2015-09-11
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactKEVIN ESCAPULE
Manufacturer StreetP.O. BOX 708
Manufacturer CityWARSAW IN 465810708
Manufacturer CountryUS
Manufacturer Postal465810708
Manufacturer Phone8006136131
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNKNOWN COONRAD/MORREY HUMERAL ASSEMBLY
Generic NameEXTREMITY PROSTHESIS
Product CodeKWR
Date Received2015-09-11
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerZIMMER INC
Manufacturer AddressP.O. BOX 708 WARSAW IN 465810708 US 465810708


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2015-09-11

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