MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor,foreign report with the FDA on 2018-12-12 for PECTUS BAR BENDER N/A 01-3905 manufactured by Biomet Microfixation.
[130338888]
Zimmer biomet complaint (b)(4). Lot number: based upon a review of inventory transactions and the customer's purchase history, there are two possible lots; 018630 and 995440. Unique identifier (udi) number: (b)(4). Foreign country: (b)(6). Customer has indicated that the product is in process of being returned to zimmer biomet for investigation. 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: 0001032347-2018-00861.
Patient Sequence No: 1, Text Type: N, H10
[130338889]
It was reported the top of the benders broke during surgery. Attempts have been made and no further information has been provided. No adverse events have been reported as a result of the malfunction.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 0001032347-2018-00860 |
MDR Report Key | 8157762 |
Report Source | DISTRIBUTOR,FOREIGN |
Date Received | 2018-12-12 |
Date of Report | 2018-12-12 |
Date of Event | 2018-07-13 |
Date Mfgr Received | 2018-11-15 |
Device Manufacturer Date | 2017-01-25 |
Date Added to Maude | 2018-12-12 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | MRS. MICHELLE COLE |
Manufacturer Street | 1520 TRADEPORT DRIVE |
Manufacturer City | JACKSONVILLE FL 32218 |
Manufacturer Country | US |
Manufacturer Postal | 32218 |
Manufacturer Phone | 9047414400 |
Manufacturer G1 | BIOMET MICROFIXATION |
Manufacturer Street | 1520 TRADEPORT DRIVE |
Manufacturer City | JACKSONVILLE FL 32218 |
Manufacturer Country | US |
Manufacturer Postal Code | 32218 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | PECTUS BAR BENDER |
Generic Name | BENDER |
Product Code | HXW |
Date Received | 2018-12-12 |
Returned To Mfg | 2019-07-02 |
Model Number | N/A |
Catalog Number | 01-3905 |
Lot Number | SEE H10 NARRATIVE |
Operator | HEALTH PROFESSIONAL |
Device Availability | R |
Device Age | DA |
Device Eval'ed by Mfgr | Y |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | BIOMET MICROFIXATION |
Manufacturer Address | 1520 TRADEPORT DRIVE JACKSONVILLE FL 32218 US 32218 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2018-12-12 |