FDA Adverse Event Injury Summary report: N

PALACOS BONE CEMENT

MDR report key: 1202333 · Received October 21, 2008

Report

Report Number
1825034-2008-00272
Event Type
Injury
Date Received
October 21, 2008
Date of Event
August 9, 2007
Report Date
September 23, 2008
Manufacturer
BIOMET INC.
Product Code
LOD
PMA / PMN Number
P810020
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. REVIEW OF DEVICE HISTORY RECORDS SHOW THAT LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION. THERE ARE WARNINGS IN THE PACKAGE INSERT THAT STATE THAT THIS TYPE OF EVENT CAN OCCUR. THERE HAVE BEEN NO TRENDS IDENTIFIED RELATED TO THIS TYPE OF EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT PARTIAL KNEE PROCEDURE IN 2005. SUBSEQUENTLY, PATIENT HAS UNDERGONE TWO (2) ARTHROSCOPIC PROCEDURES IN 2007, AND ABOUT THREE MONTHS LATER TO REMOVE BONE CEMENT FRAGMENTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PALACOS BONE CEMENT BONE CEMENT LOD BIOMET INC. N/A 003728

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R