OSTEOSELECT DEMINERALIZED BONE MATRIX PUTTY 359100

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor report with the FDA on 2019-05-08 for OSTEOSELECT DEMINERALIZED BONE MATRIX PUTTY 359100 manufactured by Bacterin International, Inc..

Event Text Entries

[145638818] A complaint was reported on (b)(6) 2019 indicating that devices containing dbm putty were labeled with a volume of 10. 0cc, however, when the pouches were opened for use, the syringes contained 5. 0cc of dbm putty. The complainant reported that three devices displaying the same defect had been implanted. There were no reported patient complications with this event. The following mdr submissions are related to this event: 3005031160-2019-00023, 3005031160-2019-00024, 3005031160-2019-00025. The complainant returned three additional devices from the same lot number. Upon opening the foil pouch on one device, it was confirmed that the dbm putty was as described by the complainant. The device was labeled as containing 10. 0cc of dbm putty, however, only contained 5. 0cc of dbm putty.
Patient Sequence No: 1, Text Type: N, H10


[145638819] A complaint was reported on (b)(6) 2019 indicating that devices containing dbm putty were labeled with a volume of 10. 0cc, however, when the pouches were opened for use, the syringes contained 5. 0cc of dbm putty. The complainant reported that three devices displaying the same defect had been implanted. The following mdr submissions are related to this event: 3005031160-2019-00023, 3005031160-2019-00024, 3005031160-2019-00025.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005031160-2019-00025
MDR Report Key8592169
Report SourceDISTRIBUTOR
Date Received2019-05-08
Date of Report2019-05-08
Date of Event2019-04-16
Date Mfgr Received2019-04-16
Device Manufacturer Date2018-05-29
Date Added to Maude2019-05-08
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. CASEY MING
Manufacturer Street664 CRUISER LANE
Manufacturer CityBELGRADE MT 59714
Manufacturer CountryUS
Manufacturer Postal59714
Manufacturer Phone4063880480
Manufacturer G1BACTERIN INTERNATIONAL, INC.
Manufacturer Street664 CRUISER LANE
Manufacturer CityBELGRADE MT 59714
Manufacturer CountryUS
Manufacturer Postal Code59714
Single Use3
Remedial ActionRC
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameOSTEOSELECT DEMINERALIZED BONE MATRIX PUTTY
Generic NameBONE VOID FILLER
Product CodeMBP
Date Received2019-05-08
Model Number359100
Lot NumberB180228-DBM
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBACTERIN INTERNATIONAL, INC.
Manufacturer Address664 CRUISER LANE BELGRADE MT 59714 US 59714


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-05-08

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