E-POLY 36MM +3 HIWALL LINER SZ23 N/A EP-108323

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 2018-10-24 for E-POLY 36MM +3 HIWALL LINER SZ23 N/A EP-108323 manufactured by Zimmer Biomet, Inc..

Event Text Entries

[124888676] (b)(4). Customer has indicated that the product will not be returned to zimmer biomet for investigation, due to the device remains implanted. The investigation is in process. Once the investigation has been completed, a follow-up mdr will be submitted. Multiple mdr reports were filed for this event, please see associated reports: 0001825034 - 2018 - 09876, 0001825034 - 2018 - 09877, 0001825034 - 2018 - 09878.
Patient Sequence No: 1, Text Type: N, H10


[124888677] It was reported patient developed infection, causing incisional drainage 2 weeks post-operative initial hip procedure. Patient was treated with oral antibiotics. The drainage resolved and incision was well healed by 7 week follow up. No further treatment required. Attempts have been made and additional information on the reported event is unavailable at this time.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001825034-2018-09875
MDR Report Key8001747
Report SourceDISTRIBUTOR,HEALTH PROFESSION
Date Received2018-10-24
Date of Report2019-02-22
Date of Event2017-04-05
Date Mfgr Received2019-02-21
Device Manufacturer Date2016-11-28
Date Added to Maude2018-10-24
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 NameE-POLY 36MM +3 HIWALL LINER SZ23
Generic NamePROSTHESIS, HIP
Product CodeMAY
Date Received2018-10-24
Model NumberN/A
Catalog NumberEP-108323
Lot Number272260
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 2018-10-24

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