MAUDE Adverse Event Report: BIOMET FRANCE S.A.R.L. REFOBACIN REVISION 1X40G BONE CEMENT, ANTIBIOTIC

Model Number N/A

Device Problem Tear, Rip or Hole in Device Packaging (2385)

Patient Problem No Patient Involvement (2645)

Event Type  Malfunction  

Manufacturer Narrative

This user facility is outside of the united states. The necessary manufacturing history to review was not provided. Current information is insufficient to permit a conclusion as to the cause of the event. Product location unknown.

Event Description

It was reported that when box of bone cement was opened, the package of powder was leaking. There was no patient involvement and no delay in a procedure as a result of the event.

Manufacturer Narrative

Udi: (b)(4).

• Brand Name: REFOBACIN REVISION 1X40G
• Type of Device: BONE CEMENT, ANTIBIOTIC
• Manufacturer (Section D): BIOMET FRANCE S.A.R.L.; plateau de lautagne bp75; valence cedex 26903 ; FR 26903
• Manufacturer (Section G): BIOMET FRANCE S.A.R.L.; plateau de lautagne bp75; valence cedex 26903 ; FR 26903
• Manufacturer Contact: elisabeth plane ; plateau de lautagne bp75; valence cedex ; 0334757591
• MDR Report Key: 5802464
• MDR Text Key: 49813496
• Report Number: 3006946279-2016-00237
• Device Sequence Number: 1
• Product Code: MBB
• Combination Product (Y/N): N
• Reporter Country Code: NL
• PMA/PMN Number: PK150850
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: FOREIGN,USER FACILITY

Reporter Occupation

• Type of Report: Initial,Followup
• Report Date: 06/20/2016

1 Device Was Involved in the Event

0 PatientS WERE Involved in the Event:

• Date FDA Received: 07/18/2016
• Is This An Adverse Event Report?: No
• Is This A Product Problem Report?: Yes

Device Operator

• Device EXPIRATION Date: 01/31/2018
• Device MODEL Number: N/A
• Device Catalogue Number: 3011630001
• Device LOT Number: A507AA2801
• OTHER Device ID Number: SEE NARRATIVE IN H10
• Was Device Available For Evaluation?: No
• Is The Reporter A Health Professional?: Yes

Was the Report Sent to FDA?

• Event Location: No Information
• Date Manufacturer Received: 11/01/2016
• Was Device Evaluated By Manufacturer?: Device Not Returned To Manufacturer
• Date Device Manufactured: 08/06/2015
• Is The Device Single Use?: Yes
• Is this a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Removal/Correction Number: N/A