TMJ SYSTEM RIGHT STANDARD OFFSET MANDIBULAR COMPONENT 50MM / 9 HOLE
Report
- Report Number
- 0001032347-2020-00526
- Event Type
- Injury
- Date Received
- October 16, 2020
- Report Date
- October 5, 2021
- Manufacturer
- BIOMET MICROFIXATION
- Product Code
- LZD
- UDI-DI
- 00841036063580
- PMA / PMN Number
- P020016
- Removal / Correction Number
- N/A
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- 003
Narratives
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.
NO FURTHER EVENT INFORMATION IS AVAILABLE AT THE TIME OF THIS REPORT.
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: 0001032347-2020-00523, 0001032347-2020-00524, AND 0001032347-2020-00525. 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. INITIAL REPORTER: PATIENT.
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 |
|---|---|---|---|---|---|---|---|
| 1158764 | TMJ SYSTEM RIGHT STANDARD OFFSET MANDIBULAR COMPONENT 50MM / 9 HOLE | JOINT, TEMPOROMANDIBULAR, IMPLANT | LZD | BIOMET MICROFIXATION | N/A | 188200 | 00841036063580 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Hospitalization| R | SEE H10 NARRATIVE. |