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 2020-03-30 for E1 RINGLOC BIPOLAR SHELL NI 110010459 manufactured by Zimmer Biomet, Inc..
[186549102]
(b)(4). Customer has indicated that the product will not be returned to zimmer biomet for investigation as the device location is unknown. Once the investigation has been completed, a follow-up mdr will be submitted udi# (b)(4). Concomitant medical products: item # 00877502802 / biolox? Head / lot # 3002512, item # unknown /unknown stem/ lot # unknown , item # unknown/ unknown liner/lot # unknown. Report source: (b)(6).
Patient Sequence No: 1, Text Type: N, H10
[186549123]
It was reported that patient underwent hip revision surgery approximately one month post-implantation due to dislocation. Attempts have been made and additional information on the reported event is unavailable at this time
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 0001825034-2020-01377 |
| MDR Report Key | 9900888 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2020-03-30 |
| Date of Report | 2020-03-30 |
| Date of Event | 2020-02-22 |
| Date Mfgr Received | 2020-03-06 |
| Device Manufacturer Date | 2019-09-07 |
| Date Added to Maude | 2020-03-30 |
| 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 | MS. CHRISTINA ARNT |
| Manufacturer Street | 56 E. BELL DR. |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal | 46582 |
| Manufacturer Phone | 5745273773 |
| Manufacturer G1 | ZIMMER BIOMET, INC. |
| Manufacturer Street | 56 E. BELL DRIVE |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 46582 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | E1 RINGLOC BIPOLAR SHELL |
| Generic Name | PROSTHESIS, HIP |
| Product Code | JDI |
| Date Received | 2020-03-30 |
| Model Number | NI |
| Catalog Number | 110010459 |
| Lot Number | 734200 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ZIMMER BIOMET, INC. |
| Manufacturer Address | 56 E. BELL DRIVE WARSAW IN 46582 US 46582 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2020-03-30 |