BEUDAMED
    FDA Adverse Event Injury Summary report: N

    OSS 7CM SEGMENTAL FEMORAL RT

    MDR report key: 10512032 · Received September 9, 2020

    Report

    Report Number
    0001825034-2020-03476
    Event Type
    Injury
    Date Received
    September 9, 2020
    Date of Event
    February 5, 2019
    Report Date
    January 5, 2021
    Manufacturer
    ZIMMER BIOMET, INC.
    Product Code
    JDI
    PMA / PMN Number
    K002757
    Removal / Correction Number
    N/A
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    BE
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 0

    THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. D4: UDI#: (B)(4). REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DHR WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. ROOT CAUSE WAS UNABLE TO BE DETERMINED. 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.

    Additional Manufacturer Narrative · 0

    THIS FOLLOW-UP IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. D11- MEDICAL PRODUCT OSS CEMENTED IM STEM 13X150 ITEM# 150367 , LOT# 379450, OSS POLY TIBIAL BUSHING, ITEM# 150476 , LOT# 678220, OSS MOD TIB BASEPLATE 79MM, ITEM# 150424 , LOT# 811420, OSS CEMENTED IM STEM 13MMX90MM, ITEM# 150362, LOT# 169330, BMET ARCOM AP PATELLA 34MM, ITEM# 11-150822 LOT# 801050, OSS AXLE ITEM# 150480 LOT# 936720 OSS REINFORCED YOKE, ITEM# 150493, LOT# 190020, OSS POLY FEMORAL BUSHINGS, ITEM# 150477 LOT# 166910, OSS POLY LOCK PIN, , ITEM# 150478 , LOT# 879820, OSS 3CM ELLIP DIAPHYSEAL SEG, ITEM# 150461, LOT# 627580, OSS POLY FEMORAL BUSHINGS, ITEM# 150477, LOT# 420580, REFOBACIN BONE CEMENT R 1X40G, ITEM# 3003940001 , LOT# A801DJ1904.

    Description of Event or Problem · 0

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

    Description of Event or Problem · 0

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

    Additional Manufacturer Narrative · 1

    (B)(4). MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 0001825034-2020-03477. MEDICAL PRODUCT: UNKNOWN OSS FEMORAL STEM. (B)(6). CUSTOMER HAS NOT INDICATED WHETHER OR NOT THE PRODUCT WILL 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.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT PATIENT UNDERWENT TREATMENT FOR A PERIPROSTHETIC FRACTURE AND, SUBSEQUENTLY, PATIENT WAS REVISED DUE TO LOOSENING OF THE FEMORAL STEM. THERE IS NO ADDITIONAL INFORMATION AT THIS TIME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    970744 OSS 7CM SEGMENTAL FEMORAL RT PROSTHESIS, KNEE JDI ZIMMER BIOMET, INC. N/A 171250

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Hospitalization| R SEE H10| SEE H10