HTR-PMI BUCKLEY RIGHT FRONTAL SPHENOID PARIETAL TEMPORAL IMPLANT N/A PM620870

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,u report with the FDA on 2020-02-10 for HTR-PMI BUCKLEY RIGHT FRONTAL SPHENOID PARIETAL TEMPORAL IMPLANT N/A PM620870 manufactured by Biomet Microfixation.

Event Text Entries

[186366439] 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. The product remains implanted in the patient, but a revision may occur at a later unspecified date at which time the device may be returned for testing. The user facility is foreign; therefore, a facility medwatch report will not be available. Report source: (b)(6).
Patient Sequence No: 1, Text Type: N, H10


[186366440] It was reported the patient had a protrusion in the frontal cranial area following implantation of a custom cranial implant. It is planned that the custom cranial implant will be removed and replaced with a newly designed custom cranial implant. No additional patient consequences were reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001032347-2020-00098
MDR Report Key9689596
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2020-02-10
Date of Report2020-03-26
Date of Event2019-10-22
Date Mfgr Received2020-03-16
Device Manufacturer Date2018-06-18
Date Added to Maude2020-02-10
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 ContactMRS. JENNIFER DELANEY
Manufacturer Street1520 TRADEPORT DRIVE
Manufacturer CityJACKSONVILLE FL 32218
Manufacturer CountryUS
Manufacturer Postal32218
Manufacturer Phone9047414400
Manufacturer G1BIOMET MICROFIXATION
Manufacturer Street1520 TRADEPORT DRIVE
Manufacturer CityJACKSONVILLE FL 32218
Manufacturer CountryUS
Manufacturer Postal Code32218
Single Use3
Previous Use Code3
Removal Correction NumberN/A
Event Type3
Type of Report3

Device Details

Brand NameHTR-PMI BUCKLEY RIGHT FRONTAL SPHENOID PARIETAL TEMPORAL IMPLANT
Generic NameCUSTOM MADE DEVICE
Product CodeFWP
Date Received2020-02-10
Model NumberN/A
Catalog NumberPM620870
Lot Number838560
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBIOMET MICROFIXATION
Manufacturer Address1520 TRADEPORT DRIVE JACKSONVILLE FL 32218 US 32218


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization; 2. Required No Informationntervention 2020-02-10

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