FEMORAL STEM 12/14 NECK TAPER N/A 00771100440

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 2020-01-23 for FEMORAL STEM 12/14 NECK TAPER N/A 00771100440 manufactured by Zimmer Biomet, Inc..

Event Text Entries

[181960584] (b)(4). Udi # (b)(4). Product has been received by zimmer biomet and the investigation is in process. Once the investigation has been completed, a follow-up mdr will be submitted.
Patient Sequence No: 1, Text Type: N, H10


[181960585] It was reported while staff was opening the implant during an initial tha, it was noticed that the distal tip of the stem had perforated its packaging and had jeopardized the sterility. Another stem was used to complete the surgery. Attempts have been made and additional information on the reported event is unavailable at this time.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001822565-2020-00278
MDR Report Key9625003
Report SourceDISTRIBUTOR,HEALTH PROFESSION
Date Received2020-01-23
Date of Report2020-01-22
Date of Event2020-01-06
Date Mfgr Received2020-01-06
Device Manufacturer Date2018-08-08
Date Added to Maude2020-01-23
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. CHRISTINA ARNT
Manufacturer Street56 E. BELL DR.
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal46582
Manufacturer Phone5745273773
Manufacturer G1ZIMMER BIOMET, INC.
Manufacturer Street56 E. BELL DRIVE
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal Code46582
Single Use3
Previous Use Code3
Removal Correction NumberN/A
Event Type3
Type of Report3

Device Details

Brand NameFEMORAL STEM 12/14 NECK TAPER
Generic NamePROSTHESIS, HIP
Product CodeMEH
Date Received2020-01-23
Returned To Mfg2020-01-16
Model NumberN/A
Catalog Number00771100440
Lot Number64026088
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerZIMMER BIOMET, INC.
Manufacturer Address56 E. BELL DRIVE WARSAW IN 46582 US 46582


Patients

Patient NumberTreatmentOutcomeDate
10 2020-01-23

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