MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-19 for PULSAVAC 00-5150-175-00 manufactured by Zimmer Surgical, Inc..
[184069283]
Questionable sterility issue: a hair was found in the inner sterile package of a pulsavac high capacity fan spray tip. Packaging and hair retained.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9853189 |
| MDR Report Key | 9853189 |
| Date Received | 2020-03-19 |
| Date of Report | 2020-02-18 |
| Date of Event | 2020-02-13 |
| Report Date | 2020-02-18 |
| Date Reported to FDA | 2020-02-18 |
| Date Reported to Mfgr | 2020-03-19 |
| Date Added to Maude | 2020-03-19 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | PULSAVAC |
| Generic Name | LAVAGE, JET |
| Product Code | FQH |
| Date Received | 2020-03-19 |
| Model Number | 00-5150-175-00 |
| Catalog Number | 00-5150-175-00 |
| Lot Number | 64159758 |
| Device Availability | Y |
| Device Age | 1 DA |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ZIMMER SURGICAL, INC. |
| Manufacturer Address | 200 WEST OHIO AVE. DOVER OH 44622 US 44622 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-03-19 |