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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET SPINE, INC. 4.0MM X 18MM VARIABLE SCREW; C-TEK MAXAN ANTERIOR CERVICAL PLATE SYSTEM

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ZIMMER BIOMET SPINE, INC. 4.0MM X 18MM VARIABLE SCREW; C-TEK MAXAN ANTERIOR CERVICAL PLATE SYSTEM Back to Search Results
Catalog Number 14-521618E
Device Problem Fracture (1260)
Patient Problem Foreign Body In Patient (2687)
Event Date 10/09/2023
Event Type  Injury  
Manufacturer Narrative
Without a product return, no product evaluation is able to be conducted.Current information is insufficient to permit a valid conclusion about the cause of this event.If additional information is obtained that adds value to the relevant content of this report and/or a conclusion can be drawn, a follow-up report will be sent.
 
Event Description
It was reported that two maxan screws fractured 4 years post-op at level c6 of a 2 level plate at c4-c6.A revision surgery was performed with the threaded part of both screws being retained in the patient; the full construct was replaced to c6/c7/t1.This is report two of two for this event.
 
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Brand Name
4.0MM X 18MM VARIABLE SCREW
Type of Device
C-TEK MAXAN ANTERIOR CERVICAL PLATE SYSTEM
Manufacturer (Section D)
ZIMMER BIOMET SPINE, INC.
10225 westmoor dr.
westminster CO 80021
Manufacturer (Section G)
ZIMMER BIOMET SPINE, INC.
10225 westmoor dr.
westminster CO 80021
Manufacturer Contact
sabrina abla
10225 westmoor dr.
westminster, CO 80021
7206965158
MDR Report Key18061866
MDR Text Key327242819
Report Number3012447612-2023-00350
Device Sequence Number1
Product Code KWQ
UDI-Device Identifier00880304984899
UDI-Public(01)00880304984899(17)260216(10)J25091
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K080646
Exemption Number5645646
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial
Report Date 11/01/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number14-521618E
Device Lot NumberJ25091
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received Not provided
Initial Date FDA Received11/02/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/16/2016
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention; Hospitalization;
Patient SexMale
Patient EthnicityNon Hispanic
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