FDA Adverse Event Injury Summary report: N

TMJ SYSTEM LEFT STANDARD MANDIBULAR COMPONENT 50MM / 9 HOLE

MDR report key: 10691201 · Received October 16, 2020

Report

Report Number
0001032347-2020-00523
Event Type
Injury
Date Received
October 16, 2020
Report Date
October 5, 2021
Manufacturer
BIOMET MICROFIXATION
Product Code
LZD
UDI-DI
00841036060329
PMA / PMN Number
P020016
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING. A DEFINITIVE ROOT CAUSE CANNOT 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.

Description of Event or Problem · 0

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

Additional Manufacturer Narrative · 1

ZIMMER BIOMET COMPLAINT (B)(4). 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: 0001032347-2020-00524, 0001032347-2020-00525, 0001032347-2020-00526. EXPLANTATION DATE IS PLANNED FOR (B)(6) 2021. MEDICAL PRODUCTS: TMJ SYSTEM LEFT STANDARD MANDIBULAR COMPONENT 50MM / 9 HOLE, PART# 24-6551, LOT# 159860. TMJ SYSTEM LEFT FOSSA COMPONENT, SMALL, PART# 24-6563, LOT# 123880. TMJ SYSTEM RIGHT FOSSA COMPONENT, SMALL, PART# 24-6562, LOT# 228220. TMJ SYSTEM RIGHT STANDARD OFFSET MANDIBULAR COMPONENT 50MM / 9 HOLE, PART# 24-6650, LOT# 188200. UNKNOWN SCREWS, PART# NI, LOT# NI. OCCUPATION¿ PATIENT.

Description of Event or Problem · 1

IT WAS REPORTED THE PATIENT WILL UNDERGO A REVISION OF BILATERAL TEMPOROMANDIBULAR JOINT IMPLANTS THIRTEEN (13) YEARS FOLLOWING IMPLANTATION DUE TO HETEROTOPIC BONE GROWTH. THE PATIENT FEELS THAT THE DEVICES HAVE WORKED WELL AND IT IS THE BONY OVERGROWTH THAT CAUSES A LIMITED RANGE OF MOTION. IT IS POSSIBLE THE IMPLANTS WILL BE REPLACED WITH A CUSTOM DEVICE. NO ADDITIONAL PATIENT CONSEQUENCES HAVE BEEN REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1158753 TMJ SYSTEM LEFT STANDARD MANDIBULAR COMPONENT 50MM / 9 HOLE JOINT, TEMPOROMANDIBULAR, IMPLANT LZD BIOMET MICROFIXATION N/A 159860 00841036060329

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R SEE H10 NARRATIVE.