MAUDE Adverse Event Report: ZIMMER BIOMET, INC. CEPHALOMEDULLARY CONNECTING BOLT INSERTER; ROD, FIXATION

Model Number N/A

Device Problems Crack (1135); Fracture (1260); Device Disinfection Or Sterilization Issue (2909)

Patient Problem No Consequences Or Impact To Patient (2199)

Event Type  malfunction  

Manufacturer Narrative

(b)(4).Additional concomitant medical products: 00249003280, cephalomedullary connecting bolt inserter, 62499514; 00249003572, captured screwdriver freehand, 62641212; 00249003280, cephalomedullary connecting bolt inserter, 636470910.(b)(6).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.Multiple mdr reports were filed for this event, please see associated reports: 0001822565 - 2018 - 01128, 0001822565 - 2018 - 01127, 0001822565 - 2018 - 01130.

Event Description

It was reported that the handle of the inserter was cracked.No adverse events have been reported as a result of the malfunction.Attempts have been made and additional information on the reported event is unavailable.

Manufacturer Narrative

(b)(4).This follow-up report is being submitted to relay additional information.Complaint sample was evaluated and the reported event was confirmed.Visual inspection of the returned screwdriver confirmed that the blue handle cracked.Also noted multiple scratches on the handle indicative of use.The device history records were reviewed for deviations and/or anomalies with no deviations/anomalies identified.Root cause was unable to 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.

• Brand Name: CEPHALOMEDULLARY CONNECTING BOLT INSERTER
• Type of Device: ROD, FIXATION
• Manufacturer (Section D): ZIMMER BIOMET, INC.; 56 e. bell drive; warsaw IN 46582
• MDR Report Key: 7298707
• MDR Text Key: 101164813
• Report Number: 0001822565-2018-01129
• Device Sequence Number: 1
• Product Code: HSB
• Combination Product (y/n): N
• PMA/PMN Number: PK091566
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: distributor,foreign,health pr
• Type of Report: Initial,Followup
• Report Date: 08/23/2018

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
• Device Operator: Physician
• Device Model Number: N/A
• Device Catalogue Number: 00249003280
• Device Lot Number: 63647091
• Other Device ID Number: (01) 00889024063556
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 01/30/2018
• Initial Date FDA Received: 02/27/2018
• Supplement Dates Manufacturer Received: 07/27/2018
• Supplement Dates FDA Received: 08/23/2018
• Is This a Reprocessed and Reused Single-Use Device?: No
• Removal/Correction Number: N/A
• Patient Sequence Number: 1