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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. DRILL PIN AND SCREW INSERTER; EXTRACTOR

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ZIMMER BIOMET, INC. DRILL PIN AND SCREW INSERTER; EXTRACTOR Back to Search Results
Model Number N/A
Device Problem Fracture (1260)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/15/2023
Event Type  malfunction  
Manufacturer Narrative
(b)(4).Customer has not indicated whether the product will be returned to zimmer biomet for investigation.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event Description
It was reported that the pin and screw inserter fractured while driving screw into femur through a/p sizer.Attempts to obtain additional information have been made; however, no more information is available at this time.
 
Manufacturer Narrative
This follow-up is being submitted to relay additional information.Visual examination of the returned product identified signs of repeated use and the tip hex feature was found to be fractured.All pieces were not returned.Medical records were not provided.Device history record (dhr) was reviewed for deviations and/ or anomalies with no deviations / anomalies identified.A definitive root cause cannot be determined.If any further information is received which would change or alter any conclusions or information, a supplemental will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
Event Description
No further event information available at the time of this report.
 
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Brand Name
DRILL PIN AND SCREW INSERTER
Type of Device
EXTRACTOR
Manufacturer (Section D)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer (Section G)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key16466199
MDR Text Key310502588
Report Number0001822565-2023-00555
Device Sequence Number1
Product Code HWB
UDI-Device Identifier00889024201637
UDI-Public(01)00889024201637(10)63659572
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
EXEMPT
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 05/18/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue Number00590102100
Device Lot Number63659572
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 02/15/2023
Initial Date FDA Received03/02/2023
Supplement Dates Manufacturer Received05/17/2023
Supplement Dates FDA Received05/18/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured04/19/2017
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Removal/Correction NumberN/A
Patient Sequence Number1
Patient Age53 YR
Patient SexMale
Patient Weight108 KG
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