MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-04-10 for ZIMMER ZNN GUIDE WIRE GRIPPER 00249001200 manufactured by Zimmer Inc.
[42531553]
(b)(4). The returned device was confirmed to have loss of function and exhibit wear and tear from indicated use. The device functioned as intended by holding sufficiently the 2. 4mm wire, but did not pass with the 3mm wire. The device was measured against the print specifications at several dimensions and it was confirmed that all measurements taken were within specification. The device history records were reviewed and the records indicated that the device met specifications at the time of manufacture. This device is used for treatment. The package insert included with the instrument specifies that the device may not perform as intended if damaged or worn. The most likely cause of the instrument not gripping the 3mm wire is wear and tear from use. This mdr was identified during an internal retrospective review to meet reporting requirements and therefore is being filed retrospectively.
Patient Sequence No: 1, Text Type: N, H10
[42531554]
It is reported that the instrument failed to grip the guide wire.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1822565-2016-01074 |
| MDR Report Key | 5566164 |
| Date Received | 2016-04-10 |
| Date of Report | 2015-09-11 |
| Date of Event | 2015-08-30 |
| Date Mfgr Received | 2015-09-11 |
| Device Manufacturer Date | 2015-04-17 |
| Date Added to Maude | 2016-04-10 |
| 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 | KEVIN ESCAPULE |
| Manufacturer Street | PO BOX 708 |
| Manufacturer City | WARSAW IN 465810708 |
| Manufacturer Country | US |
| Manufacturer Postal | 465810708 |
| Manufacturer Phone | 8006136131 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | ZIMMER ZNN GUIDE WIRE GRIPPER |
| Generic Name | HXI |
| Product Code | HXI |
| Date Received | 2016-04-10 |
| Returned To Mfg | 2015-10-21 |
| Catalog Number | 00249001200 |
| Lot Number | 63017697 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ZIMMER INC |
| Manufacturer Address | PO BOX 708 WARSAW IN 465810708 US 465810708 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2016-04-10 |