FDA Adverse Event Malfunction Summary report: N

MAXFIRE MARXMEN STRAIGHT STRAIGHT

MDR report key: 6970199 · Received October 23, 2017

Report

Report Number
0001825034-2017-09339
Event Type
Malfunction
Date Received
October 23, 2017
Date of Event
September 28, 2017
Report Date
October 28, 2017
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JDR
PMA / PMN Number
PK061776
Removal / Correction Number
N/A
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). MEDICAL DEVICES: CATALOG NUMBER: 900320 LOT NUMBER: 232850, CATALOG NUMBER: 900320 LOT NUMBER: 845670, CATALOG NUMBER: 900321 LOT NUMBER: UNKNOWN (PRODUCT WAS USED). FOREIGN: (B)(4). CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, DUE TO HOSPITAL DISCARDING IT AS BIOHAZARD. 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: 0001825034-2017-09340, 0001825034-2017-09341.

Additional Manufacturer Narrative · 1

REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DEVICE HISTORY RECORD (DHR) WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. REVIEW OF THE COMPLAINT HISTORY DETERMINED THAT NO FURTHER ACTIONS ARE REQUIRED. ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. 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.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A MENISCAL REPAIR SURGERY, THE ANCHOR OF THIS DEVICE DID NOT DEPLOY. TWO OTHER PRODUCTS EXPERIENCED THE SAME MALFUNCTION DURING THIS SURGERY. THE SURGEON USED A DIFFERENT TYPE OF DEVICE TO COMPLETE THE SURGERY. NO PATIENT HARM OR SIGNIFICANT DELAY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
749696 MAXFIRE MARXMEN STRAIGHT STRAIGHT STAPLE, FIXATION JDR ZIMMER BIOMET, INC. N/A 082290

Patients

Seq Age Sex Outcome Treatment
1