FDA Adverse Event Injury Summary report: N

DERMATOME BLADES

MDR report key: 17907230 · Received October 10, 2023

Report

Report Number
0001526350-2023-01307
Event Type
Injury
Date Received
October 10, 2023
Date of Event
August 24, 2023
Report Date
January 12, 2024
Manufacturer
ZIMMER SURGICAL, INC.
Product Code
GFD
UDI-DI
00889024375895
PMA / PMN Number
EXEMPT
Removal / Correction Number
ZFA 2023-00208
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS COMPLAINT IS RECORDED BY ZIMMER BIOMET UNDER (B)(4). ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW UP REPORT WILL BE SUBMITTED WITH THE INVESTIGATION RESULTS AND ANY ACTIONS TAKEN BY THE MANUFACTURER. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 001526350-2023-01306-01.

Additional Manufacturer Narrative · 0

THIS COMPLAINT IS RECORDED BY ZIMMER BIOMET UNDER CMP-(B)(4). FOLLOWING SECTIONS WERE UPDATED OR CORRECTED: B4, B5, D2, D4, G1, G3, G6, H1, H2, H3, H4, H6, AND H10. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. REVIEW OF THE DEVICE HISTORY RECORD IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. THE ROOT CAUSE OF THE REPORTED ISSUE IS ATTRIBUTED TO A DESIGN AND MANUFACTURING ISSUE. THE EVENT IS CONFIRMED. 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. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001526350-2023-01306-3.

Additional Manufacturer Narrative · 0

THIS COMPLAINT IS RECORDED BY ZIMMER BIOMET UNDER (B)(4). ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW UP REPORT WILL BE SUBMITTED WITH THE INVESTIGATION RESULTS AND ANY ACTIONS TAKEN BY THE MANUFACTURER. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 001526350-2023-01306-2.

Additional Manufacturer Narrative · 0

AN INVESTIGATION INTO THE REPORTED EVENT HAS BEEN INITIATED UNDER (B)(4). ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW UP REPORT WILL BE SUBMITTED WITH THE INVESTIGATION RESULTS AND ANY ACTIONS TAKEN BY THE MANUFACTURER. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 001526350-2023-01306.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING SURGERY THE DEVICE DID NOT TAKE A CLEAN PIECE OF SKIN AND THE TAKEN GRAFT WAS DAMAGED. THE TEAM SWITCHED OUT THE BLADES WITH A NEW ONE WHICH TOOK A SUCCESSFUL ADDITIONAL GRAFT. THERE WERE NO ISSUES OR COMPLAINTS AFTER THE NEW BLADE WAS USED. THERE WAS NO DELAY NOTED. DUE DILIGENCE IS IN PROCESS AND THERE IS NO ADDITIONAL INFORMATION AVAILABLE AT THIS TIME.

Description of Event or Problem · 0

THERE IS NO ADDITIONAL INFORMATION AVAILABLE REGARDING THE EVENT.

Description of Event or Problem · 0

THERE IS NO ADDITIONAL INFORMATION AVAILABLE.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING SURGERY ON (B)(6) 2023, THE DEVICE DID NOT TAKE A CLEAN PIECE OF SKIN. THE TEAM SWITCHED OUT THE BLADES WITH A NEW ONE. THERE WERE NO ISSUES OR COMPLAINTS AFTER THE NEW BLADE WAS USED. THERE WAS NO HARM OR DELAY NOTED. DUE DILIGENCE IS IN PROCESS AND THERE IS NO ADDITIONAL INFORMATION AVAILABLE. THERE WAS NO ADVERSE EVENT ASSOCIATED WITH THIS MALFUNCTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
296172 DERMATOME BLADES DERMATOME BLADE, SINGLE-USE GFD ZIMMER SURGICAL, INC. N/A 65972712 00889024375895

Patients

Seq Age Sex Outcome Treatment
1 24 YR Male Required Intervention| O