FRENCH ROD BENDER 07.02092.001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor,health profession report with the FDA on 2019-05-14 for FRENCH ROD BENDER 07.02092.001 manufactured by Zimmer Biomet Spine Inc..

Event Text Entries

[144962385] Udi number: (b)(4). The returned rod bender was evaluated. One of the pivot screws has fractured, preventing the device from being able to bend a rod. The cause is likely attributed to repetitive usage and high strength applications associated with bending cocr rods. A review of the manufacturing records did not identify any issues that would have contributed to this event. Reference report 3012447612-2019-00220.
Patient Sequence No: 1, Text Type: N, H10


[144962386] It was reported that two french rod benders were stiff during surgery. Upon evaluation at zimmer biomet spine, one bender was found to be missing a set screw in the center knob, and the other has a broken dowel pin. Another rod bender was used to complete the procedure without reported patient impacts. This is report two of two for this event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3012447612-2019-00221
MDR Report Key8607559
Report SourceDISTRIBUTOR,HEALTH PROFESSION
Date Received2019-05-14
Date of Report2019-05-14
Date of Event2019-01-08
Date Mfgr Received2019-04-19
Device Manufacturer Date2016-04-01
Date Added to Maude2019-05-14
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 ContactMS. ASHLEY MCPHERSON
Manufacturer Street10225 WESTMOOR DR. NA
Manufacturer CityWESTMINSTER CO 80021
Manufacturer CountryUS
Manufacturer Postal80021
Manufacturer Phone3034437500
Manufacturer G1ZIMMER BIOMET SPINE INC.
Manufacturer Street10225 WESTMOOR DR. NA
Manufacturer CityWESTMINSTER CO 80021
Manufacturer CountryUS
Manufacturer Postal Code80021
Single Use3
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameFRENCH ROD BENDER
Generic NameBENDER
Product CodeHXW
Date Received2019-05-14
Returned To Mfg2019-02-18
Model NumberNA
Catalog Number07.02092.001
Lot Number63028554
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerZIMMER BIOMET SPINE INC.
Manufacturer Address10225 WESTMOOR DR. NA WESTMINSTER CO 80021 US 80021


Patients

Patient NumberTreatmentOutcomeDate
10 2019-05-14

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