ENDOBON? XENOGRAFT GRANULES 0.5ML ROX05

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2018-06-21 for ENDOBON? XENOGRAFT GRANULES 0.5ML ROX05 manufactured by Biomet France S.a.r.l..

Event Text Entries

[111832873] (b)(4). Report source, foreign - event occurred in (b)(6). The device will not be returned to the manufacturer. Therefore it will not be analyzed. The device history record has been reviewed. No discrepancies were found. With the available information, the exact root cause of the event could not be determined. If any further information is found which would change or alter any conclusions or information, a supplemental will be filed accordingly. Zimmer biomet will continue to monitor for trends.
Patient Sequence No: 1, Text Type: N, H10


[111832874] It has been reported that the product endobon xenograft did not integrate. Endobon placement performed the (b)(6) 2018 and the product removal performed on (b)(6) 2018.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3006946279-2018-00211
MDR Report Key7624194
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2018-06-21
Date of Report2019-01-30
Date of Event2018-04-03
Date Mfgr Received2019-01-28
Device Manufacturer Date2017-12-06
Date Added to Maude2018-06-21
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationDENTIST
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. H BATAILLE
Manufacturer StreetPLATEAU DE LAUTAGNE BP75
Manufacturer CityVALENCE 26903
Manufacturer CountryFR
Manufacturer Postal26903
Manufacturer Phone0334757591
Manufacturer G1BIOMET FRANCE S.A.R.L.
Manufacturer StreetPLATEAU DE LAUTAGNE BP75
Manufacturer CityVALENCE CEDEX 26903
Manufacturer CountryFR
Manufacturer Postal Code26903
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameENDOBON? XENOGRAFT GRANULES 0.5ML
Generic NameBONE GRAFTING MATERIAL, SYNTHETIC
Product CodeLYC
Date Received2018-06-21
Catalog NumberROX05
Lot NumberX0133342
ID Number(01) 03599870091258
Device Expiration Date2019-05-31
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBIOMET FRANCE S.A.R.L.
Manufacturer AddressPLATEAU DE LAUTAGNE BP75 VALENCE CEDEX 26903 FR 26903


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2018-06-21

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