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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOMET MICROFIXATION OMNIMAX SD XD SCREW 2.0X7MM; SCREW, FIXATION, INTRAOSSEOUS

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BIOMET MICROFIXATION OMNIMAX SD XD SCREW 2.0X7MM; SCREW, FIXATION, INTRAOSSEOUS Back to Search Results
Model Number N/A
Device Problem Fracture (1260)
Patient Problem Foreign Body In Patient (2687)
Event Date 10/02/2021
Event Type  Injury  
Manufacturer Narrative
Zimmer biomet complaint (b)(4).Product has been received by zimmer biomet and the investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event Description
It was reported that an unknown 9mm screw broke during a procedure and remains in the patient.No additional medical intervention is required.
 
Event Description
No further event information is available at the time of this report.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.One fractured screw was returned.The fracture is of the bone thread and occurred below the second full thread from the thread runout.There is no other significant markings or anomalies that can be seen on the returned screw.Photos were supplied via email that show various fractured screws but, it is unknown which photo pertains to subject complaint so no information can be gained by the review.Lot identification is necessary for review of device history records, lot identification was not provided.A definitive root cause cannot be determined.If any further information is found which would change or alter any conclusions or information, a supplemental will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
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Brand Name
OMNIMAX SD XD SCREW 2.0X7MM
Type of Device
SCREW, FIXATION, INTRAOSSEOUS
Manufacturer (Section D)
BIOMET MICROFIXATION
1520 tradeport drive
jacksonville FL 32218
Manufacturer (Section G)
BIOMET MICROFIXATION
1520 tradeport drive
jacksonville FL 32218
Manufacturer Contact
christina arnt
1520 tradeport drive
jacksonville, FL 32218
9047414400
MDR Report Key12697887
MDR Text Key278528536
Report Number0001032347-2021-00491
Device Sequence Number1
Product Code DZL
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K143336
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Distributor
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 11/23/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received10/26/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue Number91-5707
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/13/2021
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received11/11/2021
Was Device Evaluated by Manufacturer? Yes
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Removal/Correction NumberN/A
Patient Sequence Number1
Patient Age19 YR
Patient SexMale
Patient RaceBlack Or African American
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