FDA Adverse Event Injury Summary report: N

OXFORD PKS HIGH FLEX TWIN PEG CEMENTED FEMUR MEDIUM

MDR report key: 14849596 · Received June 29, 2022

Report

Report Number
3002806535-2022-00288
Event Type
Injury
Date Received
June 29, 2022
Report Date
July 21, 2022
Manufacturer
BIOMET UK LTD.
Product Code
NRA
UDI-DI
00887868354854
PMA / PMN Number
P010014
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

(B)(4). CONCOMITANT MEDICAL PRODUCTS: OXF ANAT BRG LT MD SIZE 3 PMA ITEM#159547 LOT#6483393, OXF UNI CMNTLS TIB SZ C LM ITEM#166574 LOT#3922603, PALACOS R+G 2X40G ITEM #66017569 LOT #92804884. REPORT SOURCE: (B)(6). INVESTIGATION OF THIS INCIDENT IS CURRENTLY ONGOING. ONCE THE INVESTIGATION IS COMPLETED, A SUPPLEMENTAL MEDWATCH 3500A WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3002806535 - 2022 ¿ 00286, 3002806535 - 2022 ¿ 00287.

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED TO CONFIRM REPORTED EVENT. REVIEW OF THE DEVICE HISTORY RECORD (DHR 166942 LO# J6466714) IDENTIFIED NO DEVIATIONS DURING MANUFACTURING RELATED TO THE REPORTED EVENT. DEVICES ARE USED FOR TREATMENT. MEDICAL RECORDS WERE NOT PROVIDED. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT AN INITIAL LEFT KNEE ARTHROPLASTY AND APPROXIMATELY TWO (2) YEARS POST-IMPLANTATION IS STILL EXPERIENCING PAIN AND INSTABILITY. DUE DILIGENCE IS IN PROGRESS FOR THIS COMPLAINT; TO DATE NO ADDITIONAL INFORMATION HAS BEEN RECEIVED.

Description of Event or Problem · 0

NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1813314 OXFORD PKS HIGH FLEX TWIN PEG CEMENTED FEMUR MEDIUM KNEE PROSTHESIS NRA BIOMET UK LTD. N/A J6466714 00887868354854

Patients

Seq Age Sex Outcome Treatment
1 Female Other SEE H10 NARRATIVE