ULTRA-DRIVE 9.5 SHORT OSTEOTOM N/A 423880

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-03-26 for ULTRA-DRIVE 9.5 SHORT OSTEOTOM N/A 423880 manufactured by Zimmer Biomet, Inc..

Event Text Entries

[185117304] (b)(4). Report source: (b)(6). Products have been received by zimmer biomet and the investigation is in process. Once the investigation have been completed, a follow-up mdr will be submitted. Multiple mdr reports were filed for this event, please see associated reports: 0001825034-2020-01301, 0001825034-2020-01302, 0001825034-2020-01303.
Patient Sequence No: 1, Text Type: N, H10


[185117305] It was reported that during a hip procedure, the products bent, twisted and fractured during use. It is unknown if there was any harm or injury sustained by the patient. Attempts have been made and additional information on the reported event is unavailable at this time.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001825034-2020-01304
MDR Report Key9883224
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-03-26
Date of Report2020-03-26
Date of Event2020-03-03
Date Mfgr Received2020-03-04
Device Manufacturer Date2018-02-06
Date Added to Maude2020-03-26
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 ContactMS. CHRISTINA ARNT
Manufacturer Street56 E. BELL DR.
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal46582
Manufacturer Phone5745273773
Manufacturer G1ZIMMER BIOMET, INC.
Manufacturer Street56 E. BELL DRIVE
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal Code46582
Single Use3
Previous Use Code3
Removal Correction NumberN/A
Event Type3
Type of Report3

Device Details

Brand NameULTRA-DRIVE 9.5 SHORT OSTEOTOM
Generic NameHIP INSTRUMENT
Product CodeJDX
Date Received2020-03-26
Returned To Mfg2020-03-23
Model NumberN/A
Catalog Number423880
Lot Number537520
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerZIMMER BIOMET, INC.
Manufacturer Address56 E. BELL DRIVE WARSAW IN 46582 US 46582


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-26

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