MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-02-04 for UNKNOWN REVERSE SCREW N/A manufactured by Zimmer Biomet, Inc..
[177746395]
(b)(4). (udi): n/a. Medical product: catalog #: 00434903611, glenosphere 36 mm diameter, lot # unknown, catalog #: 00434901500, base plate 15 mm post length uncemented, lot # unknown, catalog #: unknown, unk poly, lot # unknown. Customer has indicated that the product will not be returned to zimmer biomet for investigation, as the product was discarded. The investigation is in process. Once the investigation has been completed, a follow-up mdr will be submitted. If any further information is found which would change or alter any conclusions or information, a supplemental will be filed accordingly. Zimmer biomet will continue to monitor for trends. Multiple mdr reports were filed for this event, please see associated reports: 0001822565-2020-00466, 0001822565-2020-00467. Discarded.
Patient Sequence No: 1, Text Type: N, H10
[177746396]
It was reported that the patient had an initial shoulder surgery on an unknown date. Subsequently, the patient had a revision due to insufficient bone stock in the glenoid. The doctor converted a tm reverse humeral stem to a hemi arthroplasty.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 0001822565-2020-00468 |
| MDR Report Key | 9666689 |
| Report Source | COMPANY REPRESENTATIVE,HEALTH |
| Date Received | 2020-02-04 |
| Date of Report | 2020-03-27 |
| Date of Event | 2017-11-07 |
| Date Mfgr Received | 2020-03-27 |
| Date Added to Maude | 2020-02-04 |
| 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. CHRISTINA ARNT |
| Manufacturer Street | 56 E. BELL DR. |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal | 46582 |
| Manufacturer Phone | 5745273773 |
| Manufacturer G1 | ZIMMER BIOMET, INC. |
| Manufacturer Street | 56 E. BELL DRIVE |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 46582 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | N/A |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | UNKNOWN REVERSE SCREW |
| Generic Name | FASTENER, FIXATION |
| Product Code | PAO |
| Date Received | 2020-02-04 |
| Model Number | N/A |
| Catalog Number | NI |
| Lot Number | NI |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ZIMMER BIOMET, INC. |
| Manufacturer Address | 56 E. BELL DRIVE WARSAW IN 46582 US 46582 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2020-02-04 |