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..
[157859454]
Without a product return, no product evaluation is able to be conducted. 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
[157859456]
It was reported that the tip of the probe broke and was stuck in the pedicle. The tip was retrieved. Additional bone was removed around the tip in order to remove it, but there were no changes to the planned treatment and there were no reported patient impacts.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3012447612-2019-00386 |
| MDR Report Key | 9009540 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2019-09-12 |
| Date of Report | 2019-09-12 |
| Date of Event | 2019-08-15 |
| Date Mfgr Received | 2019-08-15 |
| 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 | 63040742 |
| 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 | 2019-09-12 |