3.5X100MM RT DISCOVERY RADIAL STEM N/A CP0000114

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2018-08-24 for 3.5X100MM RT DISCOVERY RADIAL STEM N/A CP0000114 manufactured by Zimmer Biomet, Inc..

Event Text Entries

[118101458] (b)(4). The complaint is under investigation. Once the investigation is completed a follow up report will be submitted.
Patient Sequence No: 1, Text Type: N, H10


[118101459] It was reported that the patient is being considered for a custom elbow arthroplasty revision due to loosening approximately one year post implantation. No additional information is available.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001825034-2018-08419
MDR Report Key7812382
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2018-08-24
Date of Report2018-11-19
Date Mfgr Received2018-11-07
Device Manufacturer Date2017-03-07
Date Added to Maude2018-08-24
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. CHRISTINA ARNT
Manufacturer Street56 E. BELL DR.
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal46582
Manufacturer Phone5745273773
Manufacturer G1ZIMMER BIOMET, INC.
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 Name3.5X100MM RT DISCOVERY RADIAL STEM
Generic NamePROSTHESIS, ELBOW
Product CodeJDB
Date Received2018-08-24
Model NumberN/A
Catalog NumberCP0000114
Lot Number504510
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerZIMMER BIOMET, INC.
Manufacturer Address56 E. BELL DRIVE WARSAW IN 46582 US 46582


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2018-08-24

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