FDA Adverse Event Injury Summary report: N

OXF TWIN-PEG CMNTD FEM LG PMA

MDR report key: 12406913 · Received September 1, 2021

Report

Report Number
3002806535-2021-00373
Event Type
Injury
Date Received
September 1, 2021
Date of Event
August 24, 2021
Report Date
October 13, 2021
Manufacturer
BIOMET UK LTD.
Product Code
NRA
UDI-DI
05019279438259
PMA / PMN Number
P010014
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

(B)(4). 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. THE SOURCE OF PAIN CANNOT BE DETERMINED THROUGH THE RADIOGRAPHS, AS ONLY AP RADIOGRAPHS PROVIDED, NO ML VIEW SO A FULL ASSESSMENT OF SIZE, POSITION AND ALIGNMENT CANNOT BE DONE. A REVIEW OF THE MANUFACTURING HISTORY RECORDS CONFIRMS NO ABNORMALITIES OR DEVIATIONS REPORTED, (B)(6) AND (B)(6) WERE ISSUED FOR ITEM (B)(6) AND (B)(6) WAS ISSUED FOR ITEM (B)(6). A REVIEW OF THE COMPLAINT DATABASE OVER THE LAST 3 YEARS HAS FOUND (B)(4) COMPLAINTS REPORTED WITH THE ITEM (B)(6), (B)(4) COMPLAINTS REPORTED WITH THE ITEM (B)(6) AND (B)(4) COMPLAINTS REPORTED WITH THE ITEM (B)(6) (INCLUDING THE INITIATING COMPLAINT). WITHOUT THE OPPORTUNITY TO EXAMINE THE COMPLAINT PRODUCT, ROOT CAUSE CANNOT BE DETERMINED DUE TO INSUFFICIENT INFORMATION. CAPA: NO CORRECTIVE OR PREVENTIVE ACTION REQUIRED AT THIS TIME. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3002806535-2021-00372-1. 3002806535-2021-00374-1. 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT UNDERWENT AN INITIAL RIGHT KNEE ARTHROPLASTY ON (B)(6), 2016. SUBSEQUENTLY, A REVISION PROCEDURE DUE TO PAIN WAS PERFORMED ON (B)(6), 2021. ATTEMPTS HAVE BEEN MADE BUT NO FURTHER INFORMATION HAS BEEN PROVIDED AT THIS TIME.

Additional Manufacturer Narrative · 1

(B)(4). INITIAL REPORT. CUSTOMER HAS INDICATED THAT THE PRODUCT HAS BEEN DISCARDED, THEREFORE WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. MEDICAL PRODUCT: OXF UNI TIB TRAY SZ D RM PMA, CATALOG #:154725, LOT #: 734830. MEDICAL PRODUCT: OXF ANAT BRG RT LG SIZE 4 PMA, CATALOG #:159583, LOT #: 169240. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3002806535-2021-00372, 3002806535-2021-00374. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. DISCARDED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT AN INITIAL RIGHT KNEE ARTHROPLASTY ON (B)(6) 2016. SUBSEQUENTLY, A REVISION PROCEDURE DUE TO PAIN WAS PERFORMED ON (B)(6) 2021. ATTEMPTS HAVE BEEN MADE BUT NO FURTHER INFORMATION HAS BEEN PROVIDED AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1308787 OXF TWIN-PEG CMNTD FEM LG PMA OXFORD PARTIAL KNEE SYSTEM NRA BIOMET UK LTD. N/A 915290 05019279438259

Patients

Seq Age Sex Outcome Treatment
1 65 YR Hospitalization| R SEE H10 NARRATIVE.