MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2019-09-12 for PEDICLE PROBE - STRAIGHT LUMBAR 07.02067.001 manufactured by Zimmer Biomet Spine Inc..
[159608776]
Without a product return, no product evaluation is able to be conducted. The lot number is unknown; therefore the device history records are unable to be reviewed. Current information is insufficient to permit a valid conclusion about the cause of this event. If additional information is obtained that adds value to the relevant content of this report and/or a conclusion can be drawn, a follow-up report will be sent.
Patient Sequence No: 1, Text Type: N, H10
[159608777]
It was reported that during a surgical procedure, the tip of the pedicle probe fractured off. The tip was retrieved with additional bone removal and the case was completed using a larger diameter screw and dbm paste. There was surgical delay longer than 30 minutes associated with this event.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 3012447612-2019-00385 |
MDR Report Key | 9008723 |
Report Source | COMPANY REPRESENTATIVE,FOREIG |
Date Received | 2019-09-12 |
Date of Report | 2019-09-12 |
Date of Event | 2019-08-13 |
Date Mfgr Received | 2019-08-16 |
Date Added to Maude | 2019-09-12 |
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. ASHLEY MCPHERSON |
Manufacturer Street | 10225 WESTMOOR DR. NA |
Manufacturer City | WESTMINSTER CO 80021 |
Manufacturer Country | US |
Manufacturer Postal | 80021 |
Manufacturer Phone | 3034437500 |
Manufacturer G1 | ZIMMER BIOMET SPINE INC. |
Manufacturer Street | 10225 WESTMOOR DR. NA |
Manufacturer City | WESTMINSTER CO 80021 |
Manufacturer Country | US |
Manufacturer Postal Code | 80021 |
Single Use | 3 |
Previous Use Code | 3 |
Removal Correction Number | NA |
Event Type | 3 |
Type of Report | 3 |
Brand Name | PEDICLE PROBE - STRAIGHT LUMBAR |
Generic Name | PROBE |
Product Code | HXB |
Date Received | 2019-09-12 |
Model Number | NA |
Catalog Number | 07.02067.001 |
Lot Number | NI |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Eval'ed by Mfgr | R |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | ZIMMER BIOMET SPINE INC. |
Manufacturer Address | 10225 WESTMOOR DR. NA WESTMINSTER CO 80021 US 80021 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Other | 2019-09-12 |