BIPASS DISPOSABLE NITINOL PUSH ER SINGLE N/A 902092

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-09-26 for BIPASS DISPOSABLE NITINOL PUSH ER SINGLE N/A 902092 manufactured by Biomet Sports Medicine.

Event Text Entries

[55938010] The product identification necessary to review manufacturing history was not provided. Current information is insufficient to permit a conclusion as to the cause of the event. The following sections could not be completed with the limited information provided. Date of event? Ni. Initial reporter? Surgeon - ni. Manufacture date? Ni. This report is number 2 of 2 mdrs filed for the same patient (reference 1825034-2016-03803 / 03804).
Patient Sequence No: 1, Text Type: N, H10


[55938011] It was reported that there was significant resistance/friction of the nitinol needle passing through the suture punch. There was no patient injury or delay in procedure. A competitor product was used to complete this procedure.
Patient Sequence No: 1, Text Type: D, B5


[69171163] This follow-up report is being filed to relay this report is a duplicate of 1825034-2016-02271.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number0001825034-2016-03804
MDR Report Key5978065
Date Received2016-09-26
Date of Report2016-08-08
Date of Event2016-05-26
Date Mfgr Received2017-02-03
Date Added to Maude2016-09-26
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 ContactMS. MEGAN HAAS
Manufacturer Street56 E. BELL DRIVE
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal46582
Manufacturer Phone5743726700
Manufacturer G1BIOMET ORTHOPEDICS
Manufacturer Street56 E. BELL DRIVE
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal Code46582
Single Use3
Previous Use Code3
Removal Correction NumberN/A
Event Type3
Type of Report3

Device Details

Brand NameBIPASS DISPOSABLE NITINOL PUSH ER SINGLE
Generic NameORTHOPEDIC MANUAL SURGICAL INSTRUMENT
Product CodeHXO
Date Received2016-09-26
Model NumberN/A
Catalog Number902092
Lot NumberNI
ID NumberN/A
OperatorPHYSICIAN
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBIOMET SPORTS MEDICINE
Manufacturer Address56 E. BELL DRIVE WARSAW IN 46582 US 46582


Patients

Patient NumberTreatmentOutcomeDate
10 2016-09-26

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