MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor,health profession report with the FDA on 2018-08-23 for RIGHT LATERAL BENDER 14-500124 manufactured by Zimmer Biomet Spine Inc..
[117998125]
Udi number: na. Current information is insufficient to permit a valid conclusion about the cause of this event. A follow up report will be sent upon completion of the device evaluation.
Patient Sequence No: 1, Text Type: N, H10
[117998126]
It was reported that the tip of a rod bender broke off while bending a rod in-situ. The broken piece was retrieved. The surgery was able to be completed with the use of an alternative rod bender. There were no reports of patient impacts.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3012447612-2018-00709 |
| MDR Report Key | 7808610 |
| Report Source | DISTRIBUTOR,HEALTH PROFESSION |
| Date Received | 2018-08-23 |
| Date of Report | 2018-12-26 |
| Date of Event | 2018-07-26 |
| Date Mfgr Received | 2018-12-18 |
| Device Manufacturer Date | 2016-06-21 |
| Date Added to Maude | 2018-08-23 |
| 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 | MS. ASHLEY MCPHERSON |
| Manufacturer Street | 10225 WESTMOOR DR. NA |
| Manufacturer City | WESTMINSTER CO 80021 |
| Manufacturer Country | US |
| Manufacturer Postal | 80021 |
| Manufacturer Phone | 3034437500 |
| Manufacturer G1 | ZIMMER BIOMET SPINE INC. |
| Manufacturer Street | 10225 WESTMOOR DR. NA |
| Manufacturer City | WESTMINSTER CO 80021 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 80021 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | NA |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | RIGHT LATERAL BENDER |
| Generic Name | BENDER |
| Product Code | HXW |
| Date Received | 2018-08-23 |
| Returned To Mfg | 2018-08-16 |
| Model Number | NA |
| Catalog Number | 14-500124 |
| Lot Number | PY31E |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ZIMMER BIOMET SPINE INC. |
| Manufacturer Address | 10225 WESTMOOR DR. NA WESTMINSTER CO 80021 US 80021 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2018-08-23 |