FDA Adverse Event Injury Summary report: N

BMT SPLINED KNEE STM 24X80

MDR report key: 18266129 · Received December 5, 2023

Report

Report Number
0001825034-2023-02870
Event Type
Injury
Date Received
December 5, 2023
Report Date
May 7, 2024
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
K915132
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

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. H6 : MECHANICAL G4 - 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. MEDICAL RECORDS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING NO COMPLICATION DURING INITIAL SURGERY, NO OTHER INFORMATION WAS PROVIDED. 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.

Additional Manufacturer Narrative · 0

(B)(4). D10: 183324 - VNGD SSK INTLK FMRL 65 LT - 415790. 141512 - BIOMET ILOK STEM TIB TRAY 67MM - 785160. 141618 - BMT SPLINED KNEE STM 18X80 - 234140. 183862 - VNGD SSK PSC TIB BRG 12X63/67 - 324770. 11-150842 - BMET ARCOM AP PAT 3PST 34MM MD - 171810. 184244 - VNGD POST FEM AUG 65X10 LL/RM - 051700. 184144 - VNGD POST FEM AUG 65X5 RL/LM - 026050. 141742 - BIOMET TIB BLOCK 6MM 67 - 221870. 141742 - BIOMET TIB BLOCK 6MM 67 - 430830. 402283 - COBALT G-HV BONE CEMENT 40G - 161120. 402283 - COBALT G-HV BONE CEMENT 40G - 853920. 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: 0001825034-2023-02868, 0001825034-2023-02869, 0001825034-2023-02871, 0001825034-2023-02872, 0001825034-2023-02873, 0001825034-2023-02874, 0001825034-2023-02875, 0001825034-2023-02876, 0001825034-2023-02877.

Description of Event or Problem · 0

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

Description of Event or Problem · 0

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2049125 BMT SPLINED KNEE STM 24X80 PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A 517450

Patients

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