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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER SWITZERLAND MANUFACTURING GMBH NCB, CORTICAL SCREW, 5.0 MM, 22 MM; NCB PLATING SYSTEM, PROXIMAL TIBIA PLATES

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ZIMMER SWITZERLAND MANUFACTURING GMBH NCB, CORTICAL SCREW, 5.0 MM, 22 MM; NCB PLATING SYSTEM, PROXIMAL TIBIA PLATES Back to Search Results
Model Number N/A
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Nerve Damage (1979)
Event Date 01/28/2016
Event Type  Injury  
Manufacturer Narrative
The manufacturer received other source of documents for review.Where lot numbers were received for the devices, the device history records were reviewed and found to be conforming.A cause for this specific event cannot be ascertained from the information provided.As soon as supplemental information becomes available an updated report will be submitted.(b)(4).
 
Event Description
Patient was implanted on an unknown side and experienced radial nerve palsy.The device remains implanted.No revision surgery is planned.
 
Manufacturer Narrative
Investigation results were made available.Event description: it was reported that patient experiences radial nerve palsy.The ncb plate remains implanted.Review of received data: no medical data relevant to the case has been received.Due diligence: no further due diligence required as all required information to support the conclusion is available or was already requested.Product evaluation: no product was returned as it remains implanted; therefore, visual and dimensional evaluation could not be performed.Review of product documentation: device purpose: all involved devices are intended for treatment.Product compatibility: the product combination was approved by zimmer biomet.Dhr review: review of the device history records identified no deviations or anomalies during manufacturing.Instruction for use (ifu): the applicable instruction for use was reviewed.However, since no surgical report was received it was not possible to compare and evaluate possible contributing factors.Conclusion: it was reported that patient experiences radial nerve palsy.The ncb plate remains implanted.No x-rays to evaluate the implant position and other possible contributing factors were received.Patient factors that may have contributed to the reported event and relevant medical history are unknown.Due to the lack of information it was not possible to investigation if and to what extend the implanted product may have contributed to the reported event.Based on the investigation the reported event cannot be confirmed.The quality records show that all specified characteristics have met the specifications valid at the time of production.Therefore, the investigation did not identify a nonconformance or a complaint out of box (coob).Based on the given information and the results of the investigation, we were not able to identify a specific root cause for this issue.The need for corrective measures is not indicated and zimmer switzerland manufacturing gmbh considers this case as closed.Zimmer biomet's reference number of this file is (b)(4).The following reports are associated with this event: 0009613350-2020-00613-2, 0009613350-2020-00612-2, 0009613350-2021-00033-1, 0009613350-2021-00031-1, 0009613350-2021-00029-1, 0009613350-2021-00034-1, 0009613350-2021-00032-1, 0009613350-2021-00030-1, 0009613350-2020-00614-1.
 
Event Description
Investigation has been completed.
 
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Brand Name
NCB, CORTICAL SCREW, 5.0 MM, 22 MM
Type of Device
NCB PLATING SYSTEM, PROXIMAL TIBIA PLATES
Manufacturer (Section D)
ZIMMER SWITZERLAND MANUFACTURING GMBH
sulzer allee 8
sulzer industrie park
winterthur 8404
SZ  8404
MDR Report Key11206697
MDR Text Key227924479
Report Number0009613350-2021-00034
Device Sequence Number1
Product Code HRS
UDI-Device Identifier00889024290938
UDI-Public00889024290938
Combination Product (y/n)N
PMA/PMN Number
K061211
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type foreign,health professional
Type of Report Initial,Followup
Report Date 05/06/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/21/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Expiration Date07/31/2017
Device Model NumberN/A
Device Catalogue Number02.02150.022
Device Lot Number2652245
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Date Manufacturer Received04/23/2021
Is This a Reprocessed and Reused Single-Use Device? No
Removal/Correction NumberN/A
Patient Sequence Number1
Patient Outcome(s) Hospitalization;
Patient Weight58
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