RESURFACING CAGE TAMP 313-05-10

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-01-25 for RESURFACING CAGE TAMP 313-05-10 manufactured by Exactech, Inc.

Event Text Entries

[66019881] The contribution of the devices to the experience reported could not be determined as the instrument was not returned for evaluation. Additionally, the device specific information was not provided, precluding a review of the device history record.
Patient Sequence No: 1, Text Type: N, H10


[66019882] During the tamping stage for the cage (25 mm) of a resurfacing hemi, a small fracture running across the head of the humerus was caused.
Patient Sequence No: 1, Text Type: D, B5


[110091197] The contribution of the devices to the experience reported could not be determined as the instrument was not returned for evaluation. Additionally, the device specific information was not provided, precluding a review of the device history record.
Patient Sequence No: 1, Text Type: N, H10


[110091198] During the tamping stage for the cage (25mm) of a resurfacing hemi, a small fracture running across the head of the humerus was caused.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1038671-2017-00034
MDR Report Key6277461
Date Received2017-01-25
Date of Report2017-07-26
Date of Event2017-01-04
Report Date2016-10-27
Date Reported to Mfgr2016-10-27
Date Mfgr Received2016-10-27
Date Added to Maude2017-01-25
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 ContactMR GRAHAM CUTHBERT
Manufacturer Street2320 NW 66TH CT
Manufacturer CityGAINESVILLE FL 32653
Manufacturer CountryUS
Manufacturer Postal32653
Manufacturer Phone3523771140
Manufacturer G1EXACTECH, INC
Manufacturer Street2320 NW 66TH CT
Manufacturer CityGAINESVILLE FL 32653
Manufacturer CountryUS
Manufacturer Postal Code32653
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameRESURFACING CAGE TAMP
Generic NameRESURFACING CAGE TAMP
Product CodeHXG
Date Received2017-01-25
Catalog Number313-05-10
OperatorPHYSICIAN
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerEXACTECH, INC
Manufacturer Address2320 NW 66TH CT GAINESVILLE FL 32653 US 32653


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-01-25

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