BALL TIP PROBE - DUAL ENDED STIFF/FLEXIBLE - STANDARD 07.02117.001

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 2019-11-15 for BALL TIP PROBE - DUAL ENDED STIFF/FLEXIBLE - STANDARD 07.02117.001 manufactured by Zimmer Biomet Spine Inc..

Event Text Entries

[166533192] Current information is insufficient to permit a valid conclusion about the cause of this event. A follow up report will be sent upon completion of the device evaluation.
Patient Sequence No: 1, Text Type: N, H10


[166533193] It was reported that during the procedure, the tip of the probe broke off in the vertebral body. The screw was placed before they noticed it was missing and it was decided to leave the tip in patient. No additional patient impacts or surgical delays were reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3012447612-2019-00450
MDR Report Key9327801
Report SourceDISTRIBUTOR,HEALTH PROFESSION
Date Received2019-11-15
Date of Report2019-11-15
Date of Event2019-09-16
Date Mfgr Received2019-10-17
Date Added to Maude2019-11-15
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 NameBALL TIP PROBE - DUAL ENDED STIFF/FLEXIBLE - STANDARD
Generic NamePROBE
Product CodeHXB
Date Received2019-11-15
Returned To Mfg2019-11-01
Model NumberNA
Catalog Number07.02117.001
Lot NumberMC4306815
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerZIMMER BIOMET SPINE INC.
Manufacturer Address10225 WESTMOOR DR. NA WESTMINSTER CO 80021 US 80021


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-11-15

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