FDA Adverse Event Injury Summary report: N

STERNALOCK BLU SYSTEM SCREW, CANCELLOUS CROSS-DRIVE LOCKING 2.4 X 16MM

MDR report key: 7504094 · Received May 10, 2018

Report

Report Number
0001032347-2018-00265
Event Type
Injury
Date Received
May 10, 2018
Date of Event
April 9, 2018
Report Date
September 14, 2018
Manufacturer
BIOMET MICROFIXATION
Product Code
HRS
PMA / PMN Number
PK110574
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THESE PARTS WERE REMOVED IN A REVISION, THEREFORE THE COMPLAINT IS CONSIDERED CONFIRMED. THE DISTRIBUTOR REPORTED THE DEVICES WERE REMOVED DUE TO BLEEDING, HE STATED THE DEVICES DID NOT CAUSE OR CONTRIBUTE TO THE REVISION. DEVICE HISTORY RECORD (DHR) REVIEW WAS UNABLE TO BE PERFORMED AS THE LOT NUMBER OF THE DEVICE INVOLVED IN THE EVENT IS UNKNOWN. INVESTIGATION RESULTS CONCLUDED THAT THE REPORTED EVENT WAS DUE TO PATIENT CONDITION. 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. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 0001032347-2018-00266-1.

Additional Manufacturer Narrative · 1

ZIMMER BIOMET COMPLAINT (B)(4). CONCOMITANT MEDICAL PRODUCTS: BIOMET MICROFIXATION STERNALOCK BLU SYSTEM PLATE 8 HOLE X CATALOG #: 73-2623 LOT #: NI. THERAPY DATE: APR 9, 2018. 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 REPORT: 0001032347-2018-00266.

Description of Event or Problem · 1

IT WAS REPORTED A STERNAL REVISION WAS PERFORMED DUE TO THE PATIENT DEVELOPING A BLEED SIX DAYS POST-OPERATIVE. THE DISTRIBUTOR STATED THE DEVICES DID NOT CAUSE OR CONTRIBUTE TO THE EVENT. NO ADDITIONAL PATIENT CONSEQUENCES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
344405 STERNALOCK BLU SYSTEM SCREW, CANCELLOUS CROSS-DRIVE LOCKING 2.4 X 16MM BONE SCREW HRS BIOMET MICROFIXATION N/A UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R