1.5 MM SYSTEM 2 HOLE LONG STRAIGHT PLATE N/A 01-7347

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-12-01 for 1.5 MM SYSTEM 2 HOLE LONG STRAIGHT PLATE N/A 01-7347 manufactured by Biomet Microfixation.

Event Text Entries

[129021148] (b)(4). It is reported the revision is scheduled for (b)(6) 2018, however this has not been confirmed at this time. Device product code: hbw. (b)(4). Concomitant medical devices: biomet microfixation htr pmi purifoy right frontal sphenoid parietal temporal implant, catalog #: pm616540, lot #: 606120; biomet microfixation 1. 5 mm system high torque (ht), sd, x-dr, screw 1. 5 mm x 4 mm catalog #: 91-6104 lot #: 672380 therapy date: unknown. Customer has indicated that the product will not be returned to zimmer biomet for investigation, it remains implanted in the patient. 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: 0001032347-2018-00822 and 0001032347-2018-00824.
Patient Sequence No: 1, Text Type: N, H10


[129021189] It was reported the patient was involved in an accident/ "wreck" that caused the cranioplasty implant to break. A revision is planned to remove and replace the existing implant. No additional patient consequences were reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001032347-2018-00823
MDR Report Key8122146
Date Received2018-12-01
Date of Report2018-11-30
Date Mfgr Received2018-11-02
Device Manufacturer Date2015-01-26
Date Added to Maude2018-12-01
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 ContactMRS. MICHELLE COLE
Manufacturer Street1520 TRADEPORT DRIVE
Manufacturer CityJACKSONVILLE FL 32218
Manufacturer CountryUS
Manufacturer Postal32218
Manufacturer Phone9047414400
Manufacturer G1BIOMET MICROFIXATION
Manufacturer Street1520 TRADEPORT DRIVE
Manufacturer CityJACKSONVILLE FL 32218
Manufacturer CountryUS
Manufacturer Postal Code32218
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand Name1.5 MM SYSTEM 2 HOLE LONG STRAIGHT PLATE
Generic NameFASTENER, PLATE, CRANIOPLASTY
Product CodeHBW
Date Received2018-12-01
Model NumberN/A
Catalog Number01-7347
Lot Number088620
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBIOMET MICROFIXATION
Manufacturer Address1520 TRADEPORT DRIVE JACKSONVILLE FL 32218 US 32218


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization; 2. Required No Informationntervention 2018-12-01

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