MAUDE Adverse Event Report: BIOMET FRANCE S.A.R.L. ENDOBON XENOGRAFT GRANULES 0.5ML; BONE GRAFTING MATERIAL, SYNTHETIC

Model Number	N/A
Medical Device Problem Code	Failure to Osseointegrate (1863)
Health Effect - Clinical Code	Inadequate Osseointegration (2646)
Date of Event	10/30/2018
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
(b)(4).Report source, foreign - event occurred in (b)(6).The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
Event or Problem Description
It was reported that the product bone graft (endobon) did not seem to be integrated in six months even with the membrane used.The implant was placed on (b)(6) 2018 and was removed on (b)(6) 2018.
Additional Manufacturer Narrative
(b)(4).This follow-up report is being submitted to relay additional information.Concomitant medical products:- ref1 : xfosm311, item name : osseotite® 2 implant 3.25 x 11.5mm, lot number : 2016091010.Ref2 : ogf1520, item name : osseoguard flex resorbable collagen membrane 15 x 20, lot number : bdmu15l1.The device manufacturing quality record indicates that the released product met all requirements to perform as intended, and the root cause is undetermined.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.
Event or Problem Description
It has been reported that the product bone graft (endobon) did not seem to be integrated in six months even with the membrane used.The implant was placed on (b)(6)2018 and was removed on (b)(6) 2018.
Additional Manufacturer Narrative
(b)(4).This follow-up report is being submitted to relay additional information.The device manufacturing quality record indicates that the released product met all requirements to perform as intended.According to the available data, the exact root cause of the event cannot be determined.However, this complaint could be reopened if further information is received later.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.
Event or Problem Description
It has been reported that the product bone graft (endobon) did not seem to be integrated in six months even with the membrane used.The implant was placed on (b)(6) 2018 and was removed on (b)(6) 2018.

• Brand Name: ENDOBON XENOGRAFT GRANULES 0.5ML
• Common Device Name: BONE GRAFTING MATERIAL, SYNTHETIC
• Manufacturer (Section D): BIOMET FRANCE S.A.R.L.; plateau de lautagne bp75; valence cedex 26903 ; FR 26903
• MDR Report Key: 8231538
• Report Number: 3006946279-2018-00433
• Device Sequence Number: 10814026
• Product Code: LYC
• UDI-Device Identifier: 03599870091258
• UDI-Public: (01)03599870091258
• Combination Product (Y/N): N
• Initial Reporter Country: SP
• PMA/510(K) Number: K110449
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2018
• Device Explanted Year: 2018
• Reporter Type: Manufacturer
• Report Source: foreign,health professional
• Initial Reporter Occupation: Dentist
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 06/21/2019

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: Lay User/Patient
• Device Expiration Date: 06/30/2017
• Device Model Number: N/A
• Device Catalogue Number: ROX05
• Device Lot Number: V0171018
• Was Device Available for Evaluation?: No
• Was the Report Sent to FDA?: No
• Initial Date Received by Manufacturer: 11/21/2018
• Supplement Date Received by Manufacturer: 11/21/2018; 05/28/2019
• Initial Report FDA Received Date: 01/09/2019
• Supplement Report FDA Received Date: 03/13/2019; 06/21/2019
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• If action reported to FDA under 21 USC 360i(g), list FDA-assigned Recall Number or include a statement: N/A
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Hospitalization; Required Intervention