FDA Adverse Event Injury Summary report: N

BIOMET FINNED PRI STM 80X12.5

MDR report key: 18261112 · Received December 4, 2023

Report

Report Number
0001825034-2023-02861
Event Type
Injury
Date Received
December 4, 2023
Report Date
December 27, 2023
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
K142933
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4), D10: 183110 - VAN PS OPEN INTL FEM-RT 67.5 - 020610. 141213 - BIOMET ILOK PRI TIB TRAY 71MM - 863040. 183740 - VNGD PS+ TIB BRG 10X71/75MM - 101280. 11-150842 - BMET ARCOM AP PAT 3PST 34MM MD - 165150. UNKNOWN - UNKNOWN CEMENT - UNKNOWN. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION AS IT REMAINS IMPLANTED. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2023-02859, 0001825034-2023-02860, 0001825034-2023-02862, 0001825034-2023-02863.

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. H6: MECHANICAL (G04) - STEM. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. THE DEVICE HISTORY RECORD WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. PRIMARY OPERATIVE NOTES STATE NO INTRA OPERATIVE COMPLICATIONS. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL REPORT WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT A RIGHT TOTAL KNEE ARTHROPLASTY. SUBSEQUENTLY, THE PATIENT HAS HAD ONGOING TREATMENT AND THERAPY AND NOTED THE POSSIBILITY OF A REVISION. NO FURTHER OUTCOMES OR REVISIONS HAVE BEEN REPORTED. ATTEMPTS HAVE BEEN MADE AND ALL AVAILABLE INFORMATION HAS BEEN PROVIDED.

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
2177290 BIOMET FINNED PRI STM 80X12.5 PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A 455540

Patients

Seq Age Sex Outcome Treatment
1 Male Required Intervention SEE H10.