APPLICATION INSTRUMENT FOR STERNAL ZIPFIX 03.501.080

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2020-03-10 for APPLICATION INSTRUMENT FOR STERNAL ZIPFIX 03.501.080 manufactured by Wrights Lane Synthes Usa Products Llc.

Event Text Entries

[189074467] Complainant part is not expected to be returned for manufacturer review/investigation. Reporter is company representative. The investigation could not be completed; no conclusion could be drawn, as no product was received. Based on the information available, it has been determined that no corrective and/or preventative action is proposed. This complaint will be accounted for and monitored via post market surveillance activities. If additional information is made available, the investigation will be updated as applicable. Device was used for treatment, not diagnosis. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[189074468] It was reported on (b)(6) 2020, the application instrument for sternal zipfix was not properly cinching down and in need of repair. It is unknown where the issue was discovered. It is unknown if there were patient and procedure involvement. This is report 1 of 1 for (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2939274-2020-01185
MDR Report Key9810626
Report SourceCOMPANY REPRESENTATIVE
Date Received2020-03-10
Date of Report2020-02-12
Date Mfgr Received2020-02-12
Device Manufacturer Date2013-11-29
Date Added to Maude2020-03-10
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactKARA DITTY-BOVARD
Manufacturer Street1302 WRIGHTS LANE EAST
Manufacturer CityWEST CHESTER PA 19380
Manufacturer CountryUS
Manufacturer Postal19380
Manufacturer Phone6103142063
Manufacturer G1WERK H
Manufacturer StreetIM BIFANG 6
Manufacturer CityHAEGENDORF 4614
Manufacturer CountrySZ
Manufacturer Postal Code4614
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameAPPLICATION INSTRUMENT FOR STERNAL ZIPFIX
Generic NameCERCLAGE FIXATION
Product CodeJDQ
Date Received2020-03-10
Model Number03.501.080
Catalog Number03.501.080
Lot Number8726864
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerWRIGHTS LANE SYNTHES USA PRODUCTS LLC
Manufacturer Address1302 WRIGHTS LANE EAST WEST CHESTER PA 19380 US 19380


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-10

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