BENDING IRON - LEFT 2000-9046

MAUDE Adverse Event Report

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 2018-09-20 for BENDING IRON - LEFT 2000-9046 manufactured by Zimmer Biomet Spine Inc..

Event Text Entries

[120900108] Unique identifier (udi) #: ni. 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


[120900109] It was reported a torque wrench did not appear to be torquing correctly. During this same procedure, the tip of a rod bender chipped off while bending a rod. A different rod bender was used to complete the procedure. No patient harm was reported and no foreign bodies were retained. This is report two of two for this event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3012447612-2018-00776
MDR Report Key7893585
Report SourceDISTRIBUTOR,HEALTH PROFESSION
Date Received2018-09-20
Date of Report2019-01-21
Date of Event2018-08-24
Date Mfgr Received2019-01-16
Device Manufacturer Date2008-10-21
Date Added to Maude2018-09-20
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. ASHLEY MCPHERSON
Manufacturer Street10225 WESTMOOR DR. NA
Manufacturer CityWESTMINSTER CO 80021
Manufacturer CountryUS
Manufacturer Postal80021
Manufacturer Phone3034437500
Manufacturer G1ZIMMER BIOMET SPINE INC.
Manufacturer Street10225 WESTMOOR DR. NA
Manufacturer CityWESTMINSTER CO 80021
Manufacturer CountryUS
Manufacturer Postal Code80021
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameBENDING IRON - LEFT
Generic NameBENDER
Product CodeHXW
Date Received2018-09-20
Returned To Mfg2018-09-07
Model NumberNA
Catalog Number2000-9046
Lot Number080610
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerZIMMER BIOMET SPINE INC.
Manufacturer Address10225 WESTMOOR DR. NA WESTMINSTER CO 80021 US 80021


Patients

Patient NumberTreatmentOutcomeDate
10 2018-09-20

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