MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign report with the FDA on 2019-05-07 for CUSHING RONGEUR STRAIGHT 2 MM X 10 MM 00336000000 manufactured by Zimmer Biomet, Inc..
[144386490]
(b)(4). Customer has indicated that the product will not be returned to zimmer biomet for investigation, as the device was discarded by hospital. The investigation is in process. Once the investigation has been completed, a follow-up mdr will be submitted. Product not received.
Patient Sequence No: 1, Text Type: N, H10
[144386491]
It was reported that the patient underwent lumbar discectomy and while removing the loose disc fragments, the instrument broke. Surgery was prolonged by an hour. The patient retained broken rongeur jaw piece. No additional patient consequences were reported.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 0001822565-2019-01899 |
| MDR Report Key | 8588604 |
| Report Source | FOREIGN |
| Date Received | 2019-05-07 |
| Date of Report | 2019-06-19 |
| Date of Event | 2019-02-15 |
| Date Mfgr Received | 2019-06-19 |
| Device Manufacturer Date | 2008-01-16 |
| Date Added to Maude | 2019-05-07 |
| 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 | ZIMMER BIOMET, INC. |
| Manufacturer Street | 56 E. BELL DRIVE |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 46582 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | CUSHING RONGEUR STRAIGHT 2 MM X 10 MM |
| Generic Name | TRAUMA INSTRUMENTATION |
| Product Code | HTX |
| Date Received | 2019-05-07 |
| Catalog Number | 00336000000 |
| Lot Number | 60858642 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ZIMMER BIOMET, INC. |
| Manufacturer Address | 56 E. BELL DRIVE WARSAW IN 46582 US 46582 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2019-05-07 |