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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOMET MICROFIXATION 1.5MM SYSTEM TW DRILL 1.1X50MM 7MM; DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE, POWERED)

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BIOMET MICROFIXATION 1.5MM SYSTEM TW DRILL 1.1X50MM 7MM; DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE, POWERED) 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 10/25/2022
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during a procedure the twist drill fractured.The broken drill tip did not remain in the patient's body and was recovered.A different drill was used to complete the procedure.Attempts have been made and additional information on the reported event is unavailable at this time.
 
Additional Manufacturer Narrative
Zimmer biomet complaint: (b)(4).Report source: foreign: japan.Customer has indicated that the product is in process of being returned to zimmer biomet for investigation.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event or Problem Description
No further event information is available at the time of thies report.
 
Additional Manufacturer Narrative
This report is being submitted to update additional information in section b4, b5, d4, d9, g3, g6, h2, h4, h6 and h10.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.H6: component code: mechanical (g04) ¿ drill.A visual inspection was conducted on the returned drill.The drill shows signs of attempted use including marking/ scratching on the drill surface.The drill has fractured just above where the drill body meets the drill flutes.Review of the certs 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 report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
Event or Problem Description
No further event information is available at the time of this report.
 
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Brand Name
1.5MM SYSTEM TW DRILL 1.1X50MM 7MM
Common Device Name
DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE, POWERED)
Manufacturer (Section D)
BIOMET MICROFIXATION
1520 tradeport drive
jacksonville FL 32218
Manufacturer (Section G)
BIOMET MICROFIXATION
1520 tradeport drive
jacksonville FL 32218
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key15842947
Report Number0001032347-2022-00356
Device Sequence Number15180910
Product Code HBE
UDI-Device Identifier00841036013165
UDI-Public(01)00841036013165(10)350632
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K062842
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 02/01/2023
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 Number01-7144
Device Lot Number350632
Was Device Available for Evaluation? Device Returned to Manufacturer
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/27/2022
Supplement Date Received by Manufacturer01/10/2023
01/24/2023
Initial Report FDA Received Date11/22/2022
Supplement Report FDA Received Date01/12/2023
02/01/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/27/2020
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
N/A
Patient Sequence Number1
Patient SexUnknown
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