MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2019-03-19 for IBP ULNA LEFT STD INTLK N/A 114368 manufactured by Biomet Uk Ltd..
[139162894]
(b)(4). Concomitant medical products: custom lt ibp med humeral comp, catalog #: cp560539, lot #: 750420. The investigation is in process. Once the investigation has been completed, a follow-up mdr will be submitted.
Patient Sequence No: 1, Text Type: N, H10
[139162895]
Elbow revision due to unknown reasons.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3002806535-2019-00293 |
| MDR Report Key | 8431468 |
| Report Source | HEALTH PROFESSIONAL |
| Date Received | 2019-03-19 |
| Date of Report | 2019-08-28 |
| Date of Event | 2012-05-16 |
| Date Mfgr Received | 2019-08-25 |
| Device Manufacturer Date | 1997-06-13 |
| Date Added to Maude | 2019-03-19 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. CHRISTINA ARNT |
| Manufacturer Street | 56 E. BELL DR. |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal | 46582 |
| Manufacturer Phone | 5745273773 |
| Manufacturer G1 | BIOMET UK LTD. |
| Manufacturer Street | WATERTON INDUSTRIAL ESTATES |
| Manufacturer City | BRIDGEND CF313XA |
| Manufacturer Country | UK |
| Manufacturer Postal Code | CF31 3XA |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | N/A |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | IBP ULNA LEFT STD INTLK |
| Generic Name | PROSTHESIS, ELBOW |
| Product Code | JDB |
| Date Received | 2019-03-19 |
| Model Number | N/A |
| Catalog Number | 114368 |
| Lot Number | 221552 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BIOMET UK LTD. |
| Manufacturer Address | WATERTON INDUSTRIAL ESTATES BRIDGEND CF313XA UK CF31 3XA |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2019-03-19 |