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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. UNK BASEPLATE; SHOULDER PROSTHESIS, REVERSE CONFIGURATION

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ZIMMER BIOMET, INC. UNK BASEPLATE; SHOULDER PROSTHESIS, REVERSE CONFIGURATION Back to Search Results
Catalog Number UNK BASEPLATE
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Erosion (1750)
Event Type  Injury  
Event Description
It was reported by the pmi group that a patient previously underwent a revision surgery on an unknown date due to rotator cuff failure.Subsequently, the patient was later being considered for a pmi device due to bone loss and the surgeon wanting to avoid taking excess bone, but due to health issues the patient's pmi case was cancelled.Attempts have been made and no further information has been provided.
 
Manufacturer Narrative
(b)(4).No product was returned or pictures provided; visual and dimensional evaluations could not be performed.Medical records were not provided.Part and lot identification are necessary for review of device history records, neither were provided.A definitive root cause cannot be determined.If any further information is found which would change or alter any conclusions or information, a supplemental will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
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Brand Name
UNK BASEPLATE
Type of Device
SHOULDER PROSTHESIS, REVERSE CONFIGURATION
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer (Section G)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key19116493
MDR Text Key340283458
Report Number0001825034-2024-00662
Device Sequence Number1
Product Code PHX
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
NI
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial
Report Date 04/16/2024
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 Catalogue NumberUNK BASEPLATE
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 03/01/2023
Initial Date FDA Received04/16/2024
Was Device Evaluated by Manufacturer? No
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Removal/Correction NumberNI
Patient Sequence Number1
Patient Outcome(s) Other;
Patient SexMale
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