MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,user faci report with the FDA on 2020-01-15 for TMJ SYSTEM LEFT STANDARD MANDIBULAR COMPONENT N/A 24-6556 manufactured by Biomet Microfixation.
[175231793]
Zimmer biomet complaint (b)(4). The investigation is in process. Once the investigation has been completed, a follow-up mdr will be submitted. It is unknown at this time if the device will be returned for evaluation; however, an investigation of the reported event is in progress. Once the investigation is completed, a supplemental medwatch 3500a will be submitted. Multiple mdr reports were filed for this event, please see associated reports: 0001032347-2020-00068, 0001032347-2020-00070, 0001032347-2020-00071, 0001032347-2020-00072, 0001032347-2020-00073, 0001032347-2020-00074. Medical products: tmj system right standard mandibular component, part# 24-6555, lot# 842720b, tmj system left standard mandibular component, part# 24-6556, lot# 793820b, tmj system right fossa component, small, part# 24-6562, lot# 861210a, tmj system left fossa component, small, part# 24-6563, lot# 864820a, 2. 4mm system high torque (ht) cross-drive screw, part# 91-2710, lot# unk, tmj system cross drive fossa screw, part# 99-6577, lot# unk, tmj system cross drive fossa screw, part# 99-6579, lot# unk.
Patient Sequence No: 1, Text Type: N, H10
[175231894]
It was reported the patient underwent a bilateral revision of temporomandibular joint prostheses due to an unknown reason. No additional patient consequences were reported.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 0001032347-2020-00069 |
MDR Report Key | 9592359 |
Report Source | HEALTH PROFESSIONAL,USER FACI |
Date Received | 2020-01-15 |
Date of Report | 2020-01-15 |
Date Mfgr Received | 2019-12-20 |
Device Manufacturer Date | 2018-02-23 |
Date Added to Maude | 2020-01-15 |
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 | MRS. JENNIFER DELANEY |
Manufacturer Street | 1520 TRADEPORT DRIVE |
Manufacturer City | JACKSONVILLE FL 32218 |
Manufacturer Country | US |
Manufacturer Postal | 32218 |
Manufacturer Phone | 9047414400 |
Manufacturer G1 | BIOMET MICROFIXATION |
Manufacturer Street | 1520 TRADEPORT DRIVE |
Manufacturer City | JACKSONVILLE FL 32218 |
Manufacturer Country | US |
Manufacturer Postal Code | 32218 |
Single Use | 3 |
Previous Use Code | 3 |
Removal Correction Number | N/A |
Event Type | 3 |
Type of Report | 3 |
Brand Name | TMJ SYSTEM LEFT STANDARD MANDIBULAR COMPONENT |
Generic Name | JOINT, TEMPOROMANDIBULAR, IMPLANT |
Product Code | LZD |
Date Received | 2020-01-15 |
Model Number | N/A |
Catalog Number | 24-6556 |
Lot Number | 793820B |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Eval'ed by Mfgr | R |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | BIOMET MICROFIXATION |
Manufacturer Address | 1520 TRADEPORT DRIVE JACKSONVILLE FL 32218 US 32218 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2020-01-15 |