IMPACTOR FOR USE WITH 44 MM I.D. CUP N/A 00151603044

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 2018-11-14 for IMPACTOR FOR USE WITH 44 MM I.D. CUP N/A 00151603044 manufactured by Zimmer Biomet, Inc..

Event Text Entries

[127214754] (b)(4). Customer has indicated that the product will not be returned to zimmer biomet for investigation, as the product location is unknown. The investigation is in process. Once the investigation has been completed, a follow-up mdr will be submitted.
Patient Sequence No: 1, Text Type: N, H10


[127214755] It was reported that metal debris and a crack were found on the impactor. No additional information is available at this time.
Patient Sequence No: 1, Text Type: D, B5


[130027085] This follow-up report is being submitted to relay additional information. Updated: it was identified an internal software error produced and submitted an invalid device product code in the previous submissions related to this reporting. The device product code has been updated with no further changes. 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


[130027086] No further information available.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001822565-2018-06452
MDR Report Key8070226
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2018-11-14
Date of Report2018-12-11
Date of Event2018-10-15
Date Mfgr Received2018-12-11
Device Manufacturer Date2012-09-15
Date Added to Maude2018-11-14
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag0
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 NameIMPACTOR FOR USE WITH 44 MM I.D. CUP
Generic NamePROSTHESIS, HIP
Product CodeNLF
Date Received2018-11-14
Model NumberN/A
Catalog Number00151603044
Lot Number62171803
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerZIMMER BIOMET, INC.
Manufacturer Address56 E. BELL DRIVE WARSAW IN 46582 US 46582


Patients

Patient NumberTreatmentOutcomeDate
10 2018-11-14

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