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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER SURGICAL SA X-SERIES DUAL TRIGGER PIN DRVR 2.0-4.0; SURGICAL POWER TOOL

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ZIMMER SURGICAL SA X-SERIES DUAL TRIGGER PIN DRVR 2.0-4.0; SURGICAL POWER TOOL Back to Search Results
Model Number N/A
Device Problem Unintended Ejection (1234)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Manufacturer Narrative
(b)(4) investigation of this incident is currently ongoing.Once the investigation is completed, a supplemental medwatch 3500a will be submitted.
 
Event Description
It was reported that the pin driver is not able to hold the pin.This event is related to a malfunction that could potentially lead to a sterility issue/serious injury.However, no patient harm or further outcome was reported.Due diligence is in progress for this complaint; to date no additional information or product has been received.
 
Event Description
No further event information available at the time of this report.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional and/or corrected information.The following sections were updated: b4, b5, d1, d2, d9, g1, g3, g6, h1, h2, h3, h6, h11.Review of the device history record identified no deviations or anomalies during manufacturing.Device was 34 months old and is not out of box failure.The device was not returned.A definitive root cause cannot be determined.If any further information is found which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
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Brand Name
X-SERIES DUAL TRIGGER PIN DRVR 2.0-4.0
Type of Device
SURGICAL POWER TOOL
Manufacturer (Section D)
ZIMMER SURGICAL SA
3, ch. du pre fleuri
1228 plan-les-ouates
geneva CH-12 28
SZ  CH-1228
Manufacturer (Section G)
ZIMMER SURGICAL SA
3, ch. du pre fleuri
1228 plan-les-ouates
geneva CH-12 28
SZ   CH-1228
Manufacturer Contact
christina arnt
56 e. bell drive
warsaw, IN 46582
5745273773
MDR Report Key18605189
MDR Text Key334033600
Report Number0008031000-2024-00028
Device Sequence Number1
Product Code GEY
UDI-Device Identifier00889024521339
UDI-Public(01)00889024521339(11)210226(10)5014267
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,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 04/11/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/30/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Model NumberN/A
Device Catalogue Number89-8522-451-42
Device Lot Number5014267
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received04/10/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/26/2021
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Removal/Correction NumberN/A
Patient Sequence Number1
Patient SexPrefer Not To Disclose
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