MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2016-02-04 for 2.0 X 9MM SD IMF HEX SCREW N/A 91-5609 manufactured by Biomet Microfixation.
[37443546]
Without a product return, no product evaluation is able to be conducted. The lot number is unknown; therefore the device history records are unable to be reviewed. Current information is insufficient to permit a valid conclusion about the cause of this event. If additional information is obtained that adds value to the relevant content of this report and/or a conclusion can be drawn, a follow-up report will be sent. Report three of six for the same event; see also 0001032347-2016-00043, 0001032347-2016-00045, 0001032347-2016-00047, 0001032347-2016-00049 and 0001032347-2016-00050. Device product code is dzl.
Patient Sequence No: 1, Text Type: N, H10
[37443547]
A tmj tracking card was returned indicating a revision of the right mandible. Attempts for additional information were made, however no response has been received at this time.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 0001032347-2016-00046 |
| MDR Report Key | 5409863 |
| Report Source | HEALTH PROFESSIONAL |
| Date Received | 2016-02-04 |
| Date of Report | 2016-01-05 |
| Date of Event | 2015-12-22 |
| Date Mfgr Received | 2016-01-05 |
| Date Added to Maude | 2016-02-04 |
| 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 | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MRS. MICHELLE COLE |
| Manufacturer Street | 1520 TRADEPORT DRIVE |
| Manufacturer City | JACKSONVILLE FL 32218 |
| Manufacturer Country | US |
| Manufacturer Postal | 32218 |
| Manufacturer Phone | 9047414400 |
| Manufacturer G1 | BIOMET MICROFIXATION |
| Manufacturer Street | 1520 TRADEPORT DRIVE |
| Manufacturer City | JACKSONVILLE FL 32218 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 32218 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | N/A |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | 2.0 X 9MM SD IMF HEX SCREW |
| Generic Name | SCREW |
| Product Code | DZK |
| Date Received | 2016-02-04 |
| Model Number | N/A |
| Catalog Number | 91-5609 |
| Lot Number | UNKNOWN |
| ID Number | N/A |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BIOMET MICROFIXATION |
| Manufacturer Address | 1520 TRADEPORT DRIVE JACKSONVILLE FL 32218 US 32218 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2016-02-04 |