MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,other report with the FDA on 2019-03-14 for EXCEED ABT E1 FLNG CUP 32X52MM N/A EP-103252 manufactured by Biomet Uk Ltd..
[138794816]
(b)(4). Report source, foreign - event occurred in the (b)(6). Reported event was unable to be confirmed due to limited information received from the customer. Device history record (dhr) was reviewed and no discrepancies were found. Root cause was unable to be determined as the necessary information to adequately investigate the reported event was not provided. 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
[138794817]
Hip revision due to dislocation and subluxation.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3002806535-2019-00283 |
| MDR Report Key | 8420679 |
| Report Source | FOREIGN,OTHER |
| Date Received | 2019-03-14 |
| Date of Report | 2019-03-14 |
| Date of Event | 2016-03-05 |
| Date Mfgr Received | 2019-02-14 |
| Device Manufacturer Date | 2013-12-05 |
| Date Added to Maude | 2019-03-14 |
| 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 | MS. CHRISTINA ARNT |
| Manufacturer Street | 56 E. BELL DR. |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal | 46582 |
| Manufacturer Phone | 5745273773 |
| Manufacturer G1 | BIOMET UK LTD. |
| Manufacturer Street | WATERTON INDUSTRIAL ESTATES |
| Manufacturer City | BRIDGEND CF313XA |
| Manufacturer Country | UK |
| Manufacturer Postal Code | CF31 3XA |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | N/A |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | EXCEED ABT E1 FLNG CUP 32X52MM |
| Generic Name | HIP PROSTHESIS |
| Product Code | JDD |
| Date Received | 2019-03-14 |
| Model Number | N/A |
| Catalog Number | EP-103252 |
| Lot Number | 3190875 |
| Device Expiration Date | 2018-12-05 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BIOMET UK LTD. |
| Manufacturer Address | WATERTON INDUSTRIAL ESTATES BRIDGEND CF313XA UK CF31 3XA |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2019-03-14 |