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.
[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
Report Number | 0001032347-2020-00098 |
MDR Report Key | 9689596 |
Report Source | FOREIGN,HEALTH PROFESSIONAL,U |
Date Received | 2020-02-10 |
Date of Report | 2020-03-26 |
Date of Event | 2019-10-22 |
Date Mfgr Received | 2020-03-16 |
Device Manufacturer Date | 2018-06-18 |
Date Added to Maude | 2020-02-10 |
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 | HTR-PMI BUCKLEY RIGHT FRONTAL SPHENOID PARIETAL TEMPORAL IMPLANT |
Generic Name | CUSTOM MADE DEVICE |
Product Code | FWP |
Date Received | 2020-02-10 |
Model Number | N/A |
Catalog Number | PM620870 |
Lot Number | 838560 |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Age | DA |
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 | 2020-02-10 |