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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER SURGICAL SA UNIVERSAL RECIP SAW ATTACH; BURRING POWER TOOL ATTACHMENT

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ZIMMER SURGICAL SA UNIVERSAL RECIP SAW ATTACH; BURRING POWER TOOL ATTACHMENT Back to Search Results
Model Number N/A
Medical Device Problem Code Mechanical Jam (2983)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/18/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4) g2- turkey investigation of this incident is currently ongoing.Once the investigation is completed, a supplemental medwatch 3500a will be submitted.
 
Event or Problem Description
It was reported that during surgery reciprocating saw attachment stopped and did not work again.Surgery was completed with alternative device.This event is related to a malfunction that could potentially lead to a serious injury.However, no patient harm or further outcome was reported.Due diligence is in progress for this event; to date no further information has been provided.
 
Additional Manufacturer Narrative
(b)(4).This follow-up report is being submitted to relay additional and/or corrected information.The following sections were updated: b4, b5, d1, g3, g6, h2, h3, h6, h11.No product was returned, or pictures provided; visual and dimensional evaluations could not be performed.Review of the device history record identified no deviations or anomalies during manufacturing.Review of complaint history identified additional similar complaints for the reported item and no additional complaints for the reported part and serial combination.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 available at the time of this report. .
 
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Brand Name
UNIVERSAL RECIP SAW ATTACH
Common Device Name
BURRING POWER TOOL ATTACHMENT
Manufacturer (Section D)
ZIMMER SURGICAL SA
3, ch. du pre fleuri
1228 plan-les-ouates
geneva CH-12 28
SZ  CH-1228
Manufacturer (Section G)
ZIMMER SURGICAL SA
3, ch. du pre fleuri
1228 plan-les-ouates
geneva CH-12 28
SZ   CH-1228
Manufacturer Contact
christina arnt
56 e. bell drive
warsaw, IN 46582
5745273773
MDR Report Key18825974
Report Number0008031000-2024-00072
Device Sequence Number3047672
Product Code HAB
UDI-Device Identifier00889024354944
UDI-Public(01)00889024354944(11)190830(10)5012759
Combination Product (Y/N)N
Initial Reporter CountryTU
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 Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 07/23/2024
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 Number89-8509-451-20
Device Lot Number5012759
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 02/07/2024
Supplement Date Received by Manufacturer07/16/2024
Initial Report FDA Received Date03/04/2024
Supplement Report FDA Received Date07/23/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/30/2019
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 Unknown
Patient Sequence Number1
Patient SexPrefer Not To Disclose
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