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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER SURGICAL SA MOD ELEC/BATT DBL TRIG HP; BONE/JOINT SURGICAL POWER TOOL MOTOR, ELECTRIC

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ZIMMER SURGICAL SA MOD ELEC/BATT DBL TRIG HP; BONE/JOINT SURGICAL POWER TOOL MOTOR, ELECTRIC Back to Search Results
Model Number N/A
Medical Device Problem Codes Failure to Shut Off (2939); Physical Resistance/Sticking (4012)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/04/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).G2 ¿ foreign ¿ brazil.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 the trigger of the handpiece was sticking and when it was activated, the engine would not turn off.As a result, when the doctor began the technique to mill the acetabulum, the mill ended up wrapping around the scrub nurse's glove and coat, it ended up on the scrub nurse's wrist resulting in a superficial cut.Due diligence is in progress for this complaint; to date no additional information or product has been received.
 
Additional Manufacturer Narrative
Upon reassessment of the reported event, it was determined that this medwatch # (b)(4) is a duplicate of medwatch # (b)(4) which is reported under mfr 0008031000-2024-00163.Given this information, this medwatch will be voided.
 
Event or Problem Description
Upon reassessment of the reported event, it was determined this medwatch # (b)(4) is a duplicate of medwatch # (b)(4) which is reported under mfr 0008031000-2024-00163.Given this information, this medwatch will be voided.
 
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Brand Name
MOD ELEC/BATT DBL TRIG HP
Common Device Name
BONE/JOINT SURGICAL POWER TOOL MOTOR, ELECTRIC
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 Key20036665
Report Number0008031000-2024-00145
Device Sequence Number3075208
Product Code HAB
UDI-Device Identifier00889024354593
UDI-Public(01)00889024354593
Combination Product (Y/N)N
Initial Reporter CountryBR
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 Nurse
Type of Report Initial,Followup
Report Date (Section B) 10/09/2024
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? Yes
Operator of Device Health Professional
Device Model NumberN/A
Device Catalogue Number89-8507-400-00
Device Lot NumberUNKNOWN
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 07/23/2024
Supplement Date Received by Manufacturer10/02/2024
Initial Report FDA Received Date08/22/2024
Supplement Report FDA Received Date10/09/2024
Was Device Evaluated by Manufacturer? (Y/N) No
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
Outcome Attributed to Adverse Event Other;
Patient Age74 YR
Patient SexFemale
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