FDA Adverse Event Injury Summary report: N

OXFORD UNI PHASE 3 ANATOMIC MENISCAL BEARING LEFT LARGE

MDR report key: 1844338 · Received September 24, 2010

Report

Report Number
1825034-2010-00393
Event Type
Injury
Date Received
September 24, 2010
Date of Event
April 28, 2010
Report Date
August 27, 2010
Manufacturer
BIOMET UK LTD.
Product Code
NRA
PMA / PMN Number
P010014
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DEVICE MANUFACTURE DATE - SEPTEMBER 2007.CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. THERE ARE WARNINGS IN THE PACKAGE INSERT THAT STATE THAT THIS TYPE OF EVENT CAN OCCUR.(B)(4)

Additional Manufacturer Narrative · 1

REVIEW OF DEVICE HISTORY RECORDS SHOW THAT LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION. THIS REPORT FILED (B)(6) 2010.

Description of Event or Problem · 1

ACCORDING TO OPERATIVE REPORTS RECEIVED FROM BIOMET'S LEGAL DEPARTMENT, PATIENT UNDERWENT OXFORD PARTIAL KNEE PROCEDURE ON (B)(6) 2009. BIOMET'S INVOICE HISTORY REFLECTS REVISION OF THE POLYETHYLENE COMPONENT ON (B)(6) 2010. HOWEVER, BIOMET HAS NOT RECEIVED THAT PARTICULAR OPERATIVE REPORT AND, THEREFORE, RECORDS ARE INCOMPLETE AT THIS TIME. AN OPERATIVE REPORT DATED (B)(6) 2010, STATES THAT PATIENT WAS REVISED TO A TOTAL KNEE DUE TO RECURRENT DISLOCATED POLYETHYLENE.

Description of Event or Problem · 1

ACCORDING TO OPERATIVE REPORTS RECEIVED FROM BIOMET'S LEGAL DEPARTMENT, PATIENT UNDERWENT OXFORD PARTIAL KNEE PROCEDURE ON (B)(6) 2009. BIOMET'S INVOICE HISTORY REFLECTS REVISION OF THE POLYETHELENE COMPONENT ON (B)(6) 2010. HOWEVER, BIOMET HAS NOT RECEIVED THAT PARTICULAR OPERATIVE REPORT AND, THEREFORE, RECORDS ARE INCOMPLETE AT THIS TIME. AN OPERATIVE REPORT DATED (B)(6) 2010, STATES THAT PATIENT WAS REVISED TO A TOTAL KNEE DUE TO RECURRENT DISLOCATED POLYETHELENE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OXFORD UNI PHASE 3 ANATOMIC MENISCAL BEARING LEFT LARGE PROSTHESIS, KNEE NRA BIOMET UK LTD. N/A 378626

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R