MAUDE Adverse Event Report: ZIMMER SURGICAL, INC. ZIMMER AIR DERMATOME II HOSE: SYNTHES (AO), 3 M; PNEUMATIC SURGICAL POWER TOOL SYSTEM HOSE

Model Number N/A

Device Problem Gas/Air Leak (2946)

Patient Problem No Patient Involvement (2645)

Event Date 11/27/2019

Event Type  malfunction  

Manufacturer Narrative

This event has been recorded by zimmer biomet under (b)(4).Upon receipt of additional information, the product return and the investigation is complete, a follow up/final report will be submitted.

Event Description

It was reported that during the kit inspection at zimmer biomet warehouse, it has been detected that air is leaking from the end of the hose when it is tested with the compressor.There was no patient involvement or harm as a result of this malfunction.

Event Description

No additional event information is available.

Manufacturer Narrative

This event has been recorded under zimmer biomet complaint number (b)(4).This report is being filed to relay additional information.The following fields were updated/ corrected: b4, b5, d10, g4, g7, h2, h3, h4, h6, h10.On 02 jan 2020, a returned product investigation was performed on the zimmer air dermatome ii hose: synthes (ao), 3 m.The physical evaluation revealed that the o-ring that seals the airflow from the hose was mis-seated which allowed for air to leak from the hose.The results of the returned product investigation have confirmed the reported event.While the returned product investigation confirmed that the zimmer air dermatome ii hose: synthes (ao), 3 m had a mis-seated o-ring causing an air leak, it cannot be determined from the information provided what actually caused the reported event.Therefore, based on the information provided, 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.

• Brand Name: ZIMMER AIR DERMATOME II HOSE: SYNTHES (AO), 3 M
• Type of Device: PNEUMATIC SURGICAL POWER TOOL SYSTEM HOSE
• Manufacturer (Section D): ZIMMER SURGICAL, INC.; 200 west ohio avenue; dover OH 44622
• MDR Report Key: 9465311
• MDR Text Key: 197761770
• Report Number: 0001526350-2019-01158
• Device Sequence Number: 1
• Product Code: GFD
• Combination Product (y/n): N
• PMA/PMN Number: EXEMPT
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,foreig
• Type of Report: Initial,Followup
• Report Date: 01/20/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 12/13/2019
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Other
• Device Model Number: N/A
• Device Catalogue Number: 00885100203
• Device Lot Number: N/A
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 01/02/2020
• Was the Report Sent to FDA?: No
• Date Manufacturer Received: 01/07/2020
• Is This a Reprocessed and Reused Single-Use Device?: No
• Removal/Correction Number: N/A
• Patient Sequence Number: 1