BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TMJ SYSTEM CROSS DRIVE FOSSA SCREW 2.0MM X 7MM

    MDR report key: 10472043 · Received August 31, 2020

    Report

    Report Number
    0001032347-2020-00391
    Event Type
    Injury
    Date Received
    August 31, 2020
    Report Date
    March 5, 2021
    Manufacturer
    BIOMET MICROFIXATION
    Product Code
    JEY
    UDI-DI
    00841036057442
    PMA / PMN Number
    K910038
    Removal / Correction Number
    N/A
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KY, US
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 0

    (B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001032347-2020-00388-1, 0001032347-2020-00389-1, 0001032347-2020-00390-1. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. MEDICAL RECORDS WERE NOT PROVIDED. LOT IDENTIFICATION IS NECESSARY FOR REVIEW OF DEVICE HISTORY RECORDS, LOT IDENTIFICATION WAS NOT PROVIDED FOR ITEMS 99-6577. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. SINGLE-USE, STERILIZED DEVICES MANUFACTURED OR DISTRIBUTED BY ZIMMER BIOMET ARE STERILIZED IN ACCORDANCE WITH FDA REGULATIONS AND ISO STANDARDS TO A STERILITY ASSURANCE LEVEL OF 1.0 X 10-6 OR BETTER. THE USER IS REQUIRED TO STERILIZE THE SCREWS PRIOR TO THE PROCEDURE. 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 · 0

    NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

    Additional Manufacturer Narrative · 1

    ZIMMER BIOMET COMPLAINT (B)(4). THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS AS IT REMAINS IMPLANTED; HOWEVER, AN INVESTIGATION OF THE REPORTED EVENT IS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A SUPPLEMENTAL MEDWATCH 3500A WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001032347-2020-00388, 0001032347-2020-00389, 0001032347-2020-00390. CONCOMITANT MEDICAL PRODUCTS: TMJ SYSTEM LEFT STANDARD MANDIBULAR COMPONENT 50MM / 9 HOLE, PART# 24-6551, LOT# 891840D. TMJ SYSTEM LEFT FOSSA COMPONENT, SMALL, PART# 24-6563, LOT# 886880B. 2.4MM SYSTEM HIGH TORQUE (HT) CROSS-DRIVE SCREW 2.7 X 10MM, PART# 91-2710, LOT# NI. TMJ SYSTEM CROSS DRIVE FOSSA SCREW 2.0MM X 7MM, PART# 99-6577, LOT# NI. OCCUPATION ¿ PATIENT.

    Description of Event or Problem · 1

    IT WAS REPORTED BY THE PATIENT THAT THEY ARE EXPERIENCING FACIAL PAIN FOURTEEN (14) MONTHS FOLLOWING IMPLANTATION OF TEMPOROMANDIBULAR JOINT IMPLANTS ON THE LEFT SIDE. THE PATIENT WAS DIAGNOSED WITH A LEFT EAR INFECTION AND TREATED WITH BACTRIM. THE PATIENT HAS ARTHRITIS ON BOTH SIDES OF THE MOUTH AND HAS PREVIOUSLY EXPERIENCED RUBBING OF THE JOINT. NO ADDITIONAL PATIENT CONSEQUENCES HAVE BEEN REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    934840 TMJ SYSTEM CROSS DRIVE FOSSA SCREW 2.0MM X 7MM PLATE, BONE JEY BIOMET MICROFIXATION N/A UNKNOWN 00841036057442

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention