MAUDE MDR 9900441

MDR report key
9900441
Report number
0001526350-2020-00326
Event key
0
Event type
3
Date of event
2019-10-14
Date received
2020-03-30
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. CHRISTINA ARNT
Address
56 E. BELL DRIVE WARSAW IN 46582 US
Phone
574-574-5745
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ZIMMER AIR DERMATOME, COMPLETEDERMATOMEZIMMER SURGICAL, INC.GFD0088010000031067200Y R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-300

Event Narratives#

N

Patient 1

THIS EVENT HAS BEEN RECORDED UNDER ZIMMER BIOMET COMPLAINT NUMBER (B)(4). THE REPORTED EVENT WAS CONFIRMED BY THE SERVICE TECHNICIAN WHO PERFORMED THE EVALUATION AND REPAIR. ON 15 OCTOBER 2019, IT WAS REPORTED THAT A DERMATOME WAS NOT WORKING PROPERLY. THE CUSTOMER RETURNED A ZIMMER AIR DERMATOME SERIAL NUMBER (B)(4) FOR EVALUATION. EVALUATION OF THE DEVICE ON 28 OCTOBER 2019 NOTED THAT THE DERMATOME WAS OUT OF CALIBRATION AT THE ZERO AND TWENTY SETTINGS AND THAT THE MOTOR RAN ERRATICALLY. UPON FURTHER INSPECTION, IT WAS FOUND THAT THE SWIVEL WAS LOOSE. REPAIR OF THE DERMATOME OCCURRED ON 18 DECEMBER 2019 AND INVOLVED REPLACING THE MOTOR, SWIVEL, MULTIPLE BEARINGS, AND THE THROTTLE HINGE AS WELL AS RECALIBRATING THE DEVICE. THE TECHNICIAN THEN TESTED AND VERIFIED THAT THE DEVICE WAS FUNCTIONING AS INTENDED, THEN RETURNED THE DEVICE TO THE CUSTOMER WITHOUT FURTHER INCIDENT. THE DEVICE WAS TESTED, INSPECTED, AND REPAIRED. WHILE THE SERVICE TECHNICIAN FOUND THAT THE SWIVEL WAS LOOSE, THAT THE DEVICE WAS RUNNING BELOW MOTOR SPEED SPECIFICATIONS, AND THAT THE DERMATOME WAS OUT OF CALIBRATION SPECIFICATION AT THE ZERO AND TWENTY SETTINGS, ALL FAILURE MODES THAT WOULD CAUSE THE DEVICE TO NOT FUNCTION AS INTENDED, IT CANNOT BE DETERMINED FROM THE INFORMATION PROVIDED AS TO WHAT CAUSED THESE FAILURES TO OCCUR. AS SUCH, A SPECIFIC ROOT CAUSE OF THE REPORTED EVENT CANNOT BE DETERMINED. THE INVESTIGATION WAS BASED ON THE INFORMATION THAT WAS PROVIDED INITIALLY AND ANY INFORMATION THAT WAS OBTAINED THROUGHOUT THE FOLLOW-UP PROCESS. REVIEW OF THE INFORMATION PROVIDED DURING THE INVESTIGATION DETERMINED THAT THERE ARE NO FURTHER ACTIONS NEEDED AT THIS TIME. THIS COMPLAINT WILL BE TRACKED AND TRENDED FOR ANY ADVERSE TRENDS THAT MAY WARRANT FURTHER ACTION.

D

Patient 1

IT WAS REPORTED THAT THE DEVICE DOES NOT WORK. EVENT OCCURRED DURING KIT INSPECTION BEFORE SURGERY. THIS EVENT WAS IDENTIFIED IMMEDIATELY AFTER RECEIPT OF RECENT REPAIR. UPON INVESTIGATION, IT WAS DETERMINED THAT THE MOTOR RAN ERRATICALLY. NO ADVERSE EVENTS WERE REPORTED AS A RESULT OF THIS MALFUNCTION.