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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. MODULAR FLEX DRILL BIT 3.2 MM DIAMETER 30 MM LENGTH; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. MODULAR FLEX DRILL BIT 3.2 MM DIAMETER 30 MM LENGTH; PROSTHESIS, HIP Back to Search Results
Model Number N/A
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/13/2022
Type of Reportable Event Malfunction
Event or Problem Description
It was reported two continuum drill bits broke.Attempts have been made and no additional information on the reported event is available.
 
Additional Manufacturer Narrative
(b)(4).Concomitant medical products: 00879000703- modular flex drill bit 3.2 mm diameter 30 mm length- 63837149.Multiple mdr reports were filed for this event, please see associated reports: 0001822565 - 2022 - 02864.Customer has indicated that the product will not be returned to zimmer biomet for investigation, product discarded.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.H6 component code: mechanical (g04)- drill.No product was returned or pictures provided; visual and dimensional evaluations could not be performed.Review of the device history records identified no deviations or anomalies during manufacturing.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.
 
Event or Problem Description
No additional information on the reported event.
 
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Brand Name
MODULAR FLEX DRILL BIT 3.2 MM DIAMETER 30 MM LENGTH
Common Device Name
PROSTHESIS, HIP
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 Key15536690
Report Number0001822565-2022-02863
Device Sequence Number7046422
Product Code LXH
UDI-Device Identifier00889024152212
UDI-Public(01)00889024152212(11)210129(10)65010933
Combination Product (Y/N)N
Initial Reporter StateMI
Initial Reporter CountryUS
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Distributor
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 10/05/2022
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
Operator of Device Health Professional
Device Model NumberN/A
Device Catalogue Number00879000703
Device Lot Number65010933
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/13/2022
Supplement Date Received by Manufacturer10/04/2022
Initial Report FDA Received Date10/04/2022
Supplement Report FDA Received Date10/05/2022
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured01/29/2021
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
NI
Patient Sequence Number1
Patient Age45 YR
Patient SexFemale
Patient Weight73 KG
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