FDA Adverse Event Injury Summary report: N

NATURAL KNEE II CONGRUENT TIBIAL INSERT

MDR report key: 1892205 · Received October 26, 2010

Report

Report Number
1822565-2010-00984
Event Type
Injury
Date Received
October 26, 2010
Date of Event
May 22, 2008
Report Date
September 29, 2010
Manufacturer
ZIMMER, INC.
Product Code
JWH
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

EVAL SUMMARY: NO PRODUCT OR X-RAYS WERE RETURNED FOR REVIEW. WHILE A CAUSE FOR THIS SPECIFIC CLINICAL EVENT CANNOT BE ASCERTAINED FROM THE INFO PROVIDED, THE COMMON CLINICAL PRESENTATION SUGGESTS THAT THE EVENT IS RELATED TO THE ISSUES FOR WHICH ZIMMER IMPLEMENTED A CORRECTIVE ACTION FOR IN 2007. THIS CORRECTIVE ACTION INVOLVED ENHANCING THE LABELING FOR THE NATURAL KNEE II KNEE SYSTEM. REFERENCE MDR 1822565-2006-00284 FOR ADD'L INFO REGARDING THE CORRECTIVE ACTION TAKEN. REVIEW OF THE DEVICE HISTORY RECORDS DID NOT FIND ANY DEVIATIONS OR ANOMALIES. IT IS NOT SUSPECTED THAT THE PRODUCT FAILED TO MEET SPECS. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT CONTRIBUTION TO THE REPORTED PROBLEM. SHOULD ADD'L SUBSTANTIVE INFO BE RECEIVED, THE COMPLAINT WILL BE REOPENED.

Description of Event or Problem · 1

IT IS REPORTED THAT THE PT WAS REVISED FOR LOOSENING, WEAR, AND CYSTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NATURAL KNEE II CONGRUENT TIBIAL INSERT KNEE PROSTHESIS JWH ZIMMER, INC. 1465197

Patients

Seq Age Sex Outcome Treatment
1 78 YR Required Intervention TIBIAL BASEPLATE, CATALOG # 621201210, LOT#1479374| NATURAL-KNEE II SYSTEM POROUS COATED STEMMED