POL 5.5 TI CURVED THORACIC PROBE LARG 14-500137

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 2019-12-19 for POL 5.5 TI CURVED THORACIC PROBE LARG 14-500137 manufactured by Zimmer Biomet Spine Inc..

Event Text Entries

[173716472] 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. Reference report 3012447612-2019-00555.
Patient Sequence No: 1, Text Type: N, H10


[173716473] It was reported that during the procedure, while the surgeon was pulling the probes out, the tips of two probes broke off. The tips were not able to be retrieved and were retained by the patient. There were no reported surgical delays or additional patient impacts reported. This is report one of two.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3012447612-2019-00554
MDR Report Key9493598
Report SourceDISTRIBUTOR,HEALTH PROFESSION
Date Received2019-12-19
Date of Report2019-12-18
Date of Event2019-11-19
Date Mfgr Received2019-11-21
Date Added to Maude2019-12-19
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 NamePOL 5.5 TI CURVED THORACIC PROBE LARG
Generic NamePROBE
Product CodeHXB
Date Received2019-12-19
Model NumberNA
Catalog Number14-500137
Lot Number537606
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerZIMMER BIOMET SPINE INC.
Manufacturer Address10225 WESTMOOR DR. WESTMINSTER CO 80021 US 80021


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-12-19

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