FDA Adverse Event
Malfunction
Summary report: N
REFOBACIN PLUS BONE CEMENT 20
MDR report key: 6073964
·
Received November 2, 2016
Report
- Report Number
- 3006946279-2016-00420
- Event Type
- Malfunction
- Date Received
- November 2, 2016
- Date of Event
- October 6, 2016
- Report Date
- April 27, 2017
- Manufacturer
- BIOMET FRANCE S.A.R.L.
- Product Code
- MBB
- PMA / PMN Number
- PK150850
- Removal / Correction Number
- N/A
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PL
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. REVIEW OF DEVICE HISTORY RECORDS SHOW THE LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION. (B)(4). ZIMMER BIOMET (B)(4) AND PACKAGING SUPPLIER ARE IN THE PROCESS OF INITIATING MODIFICATIONS TO ADDRESS REPORTED ISSUE.
Additional Manufacturer Narrative · 1
THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION.
Additional Manufacturer Narrative · 1
THIS FOLLOW-UP REPORT IS BEING FILED TO RELAY ADDITIONAL INFORMATION, WHICH WAS UNKNOWN AT THE TIME OF THE INITIAL MEDWATCH.
Description of Event or Problem · 1
IT WAS REPORTED THAT WHEN BOX OF BONE CEMENT WAS OPENED, THE INNER PACKAGE OF POWDER WAS LEAKING INTO THE OUTER PACKAGING. THERE WAS NO PATIENT INJURY AND NO DELAY IN A PROCEDURE AS A RESULT OF THE EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 724647 | REFOBACIN PLUS BONE CEMENT 20 | BONE CEMENT, ANTIBIOTIC | MBB | BIOMET FRANCE S.A.R.L. | N/A | A418BJ1305 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |