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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOMET MICROFIXATION THINFLAP SYSTEM CROSS-DRIVE, SELF-DRILLING SCREW, 1.5 X 4 MM; FASTENER, SCREW, CRANIOPLASTY

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BIOMET MICROFIXATION THINFLAP SYSTEM CROSS-DRIVE, SELF-DRILLING SCREW, 1.5 X 4 MM; FASTENER, SCREW, CRANIOPLASTY Back to Search Results
Model Number N/A
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Unspecified Infection (1930)
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
(b)(4).Report source: (b)(6).Customer has indicated that the product will not be returned to zimmer biomet for investigation.The investigation is in process.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:0001032347-2019-00141, 0001032347-2019-00150, & 0001032347-2019-00151.
 
Event or Problem Description
It was reported a revision will occur due to the patient evolving with an infectious disease.This patient is planned to be implanted with a pekk implant.Attempts have been made and no further information has been provided.No additional patient consequences were reported.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Reported event was confirmed by review of evidence that supports the revision was performed.As these parts were removed in revision, the complaint is considered confirmed.No product was returned and no inspection could be performed.No x-rays, scans, pictures, or physician's reports were provided.Dhr was reviewed and no discrepancies were found.There was nothing to indicate that the infection is related to these implants or there was an alleged malfunction of these implants.There are no indications of manufacturing defects.Root cause was unable to 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.Ultiple mdr reports were filed for this event, please see associated reports:0001032347-2019-00141-1, 0001032347-2019-00150-1, & 0001032347-2019-00151-1.
 
Event or Problem Description
This follow-up report is being submitted to relay additional information.
 
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Brand Name
THINFLAP SYSTEM CROSS-DRIVE, SELF-DRILLING SCREW, 1.5 X 4 MM
Common Device Name
FASTENER, SCREW, CRANIOPLASTY
Manufacturer (Section D)
BIOMET MICROFIXATION
1520 tradeport drive
jacksonville FL 32218
MDR Report Key8396576
Report Number0001032347-2019-00152
Device Sequence Number3219302
Product Code HBW
UDI-Device Identifier00841036134808
UDI-Public00841036134808
Combination Product (Y/N)N
Initial Reporter CountryCI
PMA/510(K) Number
K121624
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source company representative,foreig
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 07/01/2019
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? No
Operator of Device Health Professional
Device Model NumberN/A
Device Catalogue Number91-6704
Device Lot Number092700
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Initial Date Received by Manufacturer 02/04/2019
Supplement Date Received by Manufacturer06/11/2019
Initial Report FDA Received Date03/06/2019
Supplement Report FDA Received Date07/01/2019
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
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