BEUDAMED
    FDA Adverse Event Injury Summary report: N

    AVANTAGE RELOAD CUP TI HA S44

    MDR report key: 11593982 · Received March 31, 2021

    Report

    Report Number
    3006946279-2021-00028
    Event Type
    Injury
    Date Received
    March 31, 2021
    Date of Event
    July 28, 2020
    Report Date
    May 28, 2021
    Manufacturer
    BIOMET FRANCE S.A.R.L.
    Product Code
    KWA
    PMA / PMN Number
    N/A
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 0

    (B)(4). THE PRODUCT ANALYSIS CAN'T BE PERFORMED AS THE PRODUCT WAS NOT RETURNED (REMAINS IMPLANTED). THE DEVICE MANUFACTURING QUALITY RECORD INDICATES THAT THE RELEASED PRODUCT MET ALL REQUIREMENTS TO PERFORM AS INTENDED. RESULTS FROM MICROBIOLOGY ANALYSIS WERE RECEIVED, AND ALLOWED TO CONFIRM THE REPORTED INFECTION. ACCORDING TO THESE RESULTS, THE REPORTED EVENT WAS DUE TO BACTERIAL INFECTION TO STAPHYLOCOCCUS EPIDERMIDIS, WHICH IS A NORMAL COLONIZER OF THE SKIN. COMPLAINT EXTRACT WAS DONE REGARDING MEDICAL INFECTION: 1 COMPLAINT (1 PRODUCT), THIS ONE INCLUDED, HAS BEEN RECORDED ON AVANTAGE RELOAD CUP TI HA S44, REFERENCE (B)(4), FROM (B)(6) 2018 TO (B)(6) 2021. 1 COMPLAINT (1 PRODUCT), THIS ONE INCLUDED, HAS BEEN RECORDED ON AVANTAGE RELOAD CUP TI HA S44, REFERENCE (B)(4), BATCH 0001219576, SINCE EVER. INVESTIGATION RESULTS CONCLUDED THAT THE REPORTED EVENT WAS DUE TO BACTERIAL INFECTION TO STAPHYLOCOCCUS EPIDERMIDIS, WHICH IS A NORMAL COLONIZER OF SKIN. THERE IS NO EVIDENCE THAT THE EVENT IS RELATED TO THE PRODUCT. THE COMPLAINT IS CLOSED BUT COULD BE REOPENED IF NEW INFORMATION IS RECEIVED LATER. 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

    IT WAS REPORTED THAT THE PATIENT WAS RECEIVED ON (B)(6) 2020 AT THE CLINIC AND UNDERWENT ON (B)(6) 2020 A CLEANING AND WASHING OF THE JOINT FOLLOWING A BACTERIAL INFECTION TO STAPHYLOCOCCUS EPIDERMIDIS, WHICH IS A NORMAL COLONIZER OF SKIN.

    Additional Manufacturer Narrative · 1

    (B)(4). REPORT SOURCE, FOREIGN - EVENT OCCURRED IN (B)(6). LIST OF ASSOCIATED DEVICES: AVANTAGE INLAY S44 / 22,2 ; ITEM # P0560044; LOT # 0001439499; MANUFACTURED BY ZB VALENCE. EXCEPTION STD STEM LEFT SIZE 1; ITEM #PS125Y01; LOT #0001270155; MANUFACTURED BY ZB VALENCE. COCR FM HD D22,2/ 12-14/ +2/ L ; ITEM #P0206L22; LOT #J6382918; MANUFACTURED BY ZB VALENCE. THE DEVICE MANUFACTURING QUALITY RECORDS ALL INDICATE THAT THE RELEASED PRODUCTS MET ALL REQUIREMENTS TO PERFORM AS INTENDED. THE INVESTIGATION IS IN PROGRESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL WILL BE FILED ACCORDINGLY.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PATIENT WAS RECEIVED ON (B)(6) 2020 AT THE CLINIC AND UNDERWENT ON (B)(6) 2020 A CLEANING AND WASHING OF THE JOINT FOLLOWING A BACTERIAL INFECTION TO STAPHYLOCOCCUS EPIDERMIDIS, WHICH IS A NORMAL COLONIZER OF SKIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    492773 AVANTAGE RELOAD CUP TI HA S44 ACETABULAR SHELL KWA BIOMET FRANCE S.A.R.L. 0001219576

    Patients

    Seq Age Sex Outcome Treatment
    1 83 YR Hospitalization| R ASSOCIATED DEVICES LISTED IN SECTION H10.| ASSOCIATED DEVICES LISTED IN SECTION H10.