2G OTOMIMIX N/A 7014-3266

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor,foreign report with the FDA on 2019-05-03 for 2G OTOMIMIX N/A 7014-3266 manufactured by Biomet Microfixation.

Event Text Entries

[143963777] Zimmer biomet complaint (b)(4). Lot number - possible lot numbers are: 016570, 582090, 402320. Expiration date - lot 016570: june 2, 2020; lot 582090: may 2, 2020; lot 402320: november 1, 2019. Health professional - initial reporter has an email associated with a hospital. Occupation - initial reporter has an email associated with a hospital, no other information. Initial reporter also sent report to fda - the user facility is foreign; therefore a facility medwatch report will not be available. Report source - (b)(6). Device manufacture date - lot 016570: june 2, 2018; lot 582090: may 2, 2018; lot 402320: november 1, 2017. Customer has indicated that the product will not be returned to zimmer biomet for investigation as it was discarded. 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


[143963778] It was reported that the customer has experienced an issue during surgery where the product has been too loose or too dry, but still not hardened after 10 minutes. The exact duration of the surgical delay was not provided, but it was reported that there was a delay in surgery exceeding 30 minutes. No additional patient consequences were reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001032347-2019-00263
MDR Report Key8577710
Report SourceDISTRIBUTOR,FOREIGN
Date Received2019-05-03
Date of Report2019-07-31
Date Mfgr Received2019-07-29
Date Added to Maude2019-05-03
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. MERRIANNE CASSIDY
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
Removal Correction NumberN/A
Event Type3
Type of Report3

Device Details

Brand Name2G OTOMIMIX
Generic NameCEMENT, STOMAL APPLIANCE, OSTOMY
Product CodeNEA
Date Received2019-05-03
Model NumberN/A
Catalog Number7014-3266
Lot NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBIOMET MICROFIXATION
Manufacturer Address1520 TRADEPORT DRIVE JACKSONVILLE FL 32218 US 32218


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2019-05-03

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