FDA Adverse Event Injury Summary report: N

OXF ANAT BRG RT MD SIZE 3 PMA

MDR report key: 11965376 · Received June 9, 2021

Report

Report Number
3002806535-2021-00247
Event Type
Injury
Date Received
June 9, 2021
Date of Event
March 8, 2021
Report Date
August 11, 2021
Manufacturer
BIOMET UK LTD.
Product Code
NRA
UDI-DI
05019279786213
PMA / PMN Number
P010014
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

(B)(4). THIS FINAL REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. COMPLAINT SUMMARY: AS THE PRODUCT HAS NOT BEEN RECEIVED, THE INVESTIGATION WAS LIMITED TO THE INFORMATION PROVIDED; A REVIEW OF DEVICE HISTORY RECORDS AND COMPLAINT HISTORY. IN ADDITION, WE HAVE NOT BEEN PROVIDED WITH ANY SUPPORTING DOCUMENTATION WHICH COULD PROVIDE ADDITIONAL INFORMATION. A REVIEW OF THE MANUFACTURING HISTORY RECORDS CONFIRMS NO ABNORMALITIES OR DEVIATIONS REPORTED. A REVIEW OF THE COMPLAINT DATABASE OVER THE LAST 3 YEARS HAS FOUND 1 COMPLAINT REPORTED WITH THE ITEM 154723, 1 COMPLAINT REPORTED WITH THE ITEM 161469, AND 2 COMPLAINTS REPORTED WITH THE ITEM 159575 (INCLUDING INITIATING COMPLAINT). WITHOUT THE OPPORTUNITY TO EXAMINE THE COMPLAINT PRODUCT, ROOT CAUSE CANNOT BE DETERMINED DUE TO INSUFFICIENT INFORMATION. IF ANY ADDITIONAL INFORMATION BECOMES AVAILABLE, THEN THE COMPLAINT WILL BE REOPENED AND INVESTIGATED THOROUGHLY. CAPA: NO CORRECTIVE OR PREVENTIVE ACTION REQUIRED AT THIS TIME. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3002806535-2021-00245-2; 3002806535-2021-00246-2. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL WILL BE SUBMITTED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: A1, A2, B4, B5, G3, G6, H1, H2, H10 ADDITIONAL INFORMATION RECEIVED: PATIENT¿S INFORMATION RECEIVED: PATIENT NAME: (B)(6) AGE: 60 YEARS THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem · 0

MYMOBILITY CLINICAL STUDY REPORTED THAT A PATIENT UNDERWENT AN INITIAL PARTIAL RIGHT KNEE ARTHROPLASTY ON (B)(6) 2020. SUBSEQUENTLY, THE PATIENT EXPERIENCED PES BURSA WHICH ONSET ON (B)(6) 2021. THE SEVERITY WAS REPORTED AS MILD. TREATMENT: STEROID INJECTION. NOT DEVICE RELATED. POSSIBLY PROCEDURE RELATED.

Description of Event or Problem · 0

MYMOBILITY CLINICAL STUDY REPORTED THAT A PATIENT UNDERWENT AN INITIAL PARTIAL RIGHT KNEE ARTHROPLASTY ON (B)(6) 2020. SUBSEQUENTLY, THE PATIENT EXPERIENCED PES BURSA WHICH ONSET ON (B)(6) 2021. THE SEVERITY WAS REPORTED AS MILD. TREATMENT: STEROID INJECTION NOT DEVICE RELATED. POSSIBLY PROCEDURE RELATED. OUTCOME: TOLERATED.

Additional Manufacturer Narrative · 1

(B)(4). INITIAL REPORT. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS IT REMAINS IMPLANTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3002806535-2021-00245. 3002806535-2021-00246. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem · 1

(B)(6) CLINICAL STUDY REPORTED THAT A PATIENT UNDERWENT AN INITIAL PARTIAL RIGHT KNEE ARTHROPLASTY ON (B)(6) 2020. SUBSEQUENTLY, THE PATIENT EXPERIENCED PES BURSA WHICH ONSET ON (B)(6) 2021. THE SEVERITY WAS REPORTED AS MILD. TREATMENT: STEROID INJECTION. NOT DEVICE RELATED. POSSIBLY PROCEDURE RELATED. OUTCOME: TOLERATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
861390 OXF ANAT BRG RT MD SIZE 3 PMA OXFORD HXLPE BEARINGS NRA BIOMET UK LTD. N/A 465190 05019279786213

Patients

Seq Age Sex Outcome Treatment
1 60 YR Other