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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARTHREX, INC. ECLIPSE TRUNION 45MM, SLOTTED, TPS CAP; TOTAL SHOULDER ARTHROPLASTY SYSTEM

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ARTHREX, INC. ECLIPSE TRUNION 45MM, SLOTTED, TPS CAP; TOTAL SHOULDER ARTHROPLASTY SYSTEM Back to Search Results
Model Number ECLIPSE TRUNION 45MM, SLOTTED, TPS CAP
Device Problem Positioning Problem (3009)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 07/15/2021
Event Type  Injury  
Manufacturer Narrative
The contribution of the device to the reported event could not be determined as the device was not returned for evaluation.The root cause of the event could not be determined from the information available and without device evaluation.If the device becomes available for evaluation, a follow-up report will be submitted.
 
Event Description
It was reported during a total shoulder arthroplasty, when the surgeon was going to use the eclipse, it was not sitting well and the surgeon diverted to an univers head and apex stem.No patient harm.
 
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Brand Name
ECLIPSE TRUNION 45MM, SLOTTED, TPS CAP
Type of Device
TOTAL SHOULDER ARTHROPLASTY SYSTEM
Manufacturer (Section D)
ARTHREX, INC.
1370 creekside boulevard
naples FL 34108 1945
Manufacturer (Section G)
ARTHREX, INC.
1370 creekside boulevard
naples FL 34108 1945
Manufacturer Contact
vik bajnath
8009337001
MDR Report Key12306237
MDR Text Key265975044
Report Number1220246-2021-03509
Device Sequence Number1
Product Code QHQ
UDI-Device Identifier00888867276154
UDI-Public00888867276154
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K183914
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type distributor
Reporter Occupation Administrator/Supervisor
Type of Report Initial
Report Date 08/11/2021
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? No
Device Operator Health Professional
Device Model NumberECLIPSE TRUNION 45MM, SLOTTED, TPS CAP
Device Catalogue NumberAR-9301-45CPC
Device Lot Number19.04117
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 07/22/2021
Initial Date FDA Received08/11/2021
Date Device Manufactured05/01/2020
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) Other;
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