FDA Adverse Event Injury Summary report: N

VANGUARD PS TIBIAL TRIAL POST

MDR report key: 1894500 · Received November 9, 2010

Report

Report Number
1825034-2010-00510
Event Type
Injury
Date Received
November 9, 2010
Date of Event
October 9, 2010
Report Date
October 12, 2010
Manufacturer
BIOMET ORTHOPEDICS
Product Code
IQO
PMA / PMN Number
EXEMPT
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE LOT NUMBER INFORMATION NEEDED TO REVIEW DEVICE HISTORY RECORDS WAS UNAVAILABLE. THIS REPORT SUBMITTED (B)(6) 2010.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT TOTAL KNEE ARTHROPLASTY ON (B)(6) 2010. SUBSEQUENTLY, AT ONE MONTH POST-OPERATIVE RADIOGRAPHS, SURGEON NOTED THAT THE TIBIAL TRIAL POST WAS IMPLANTED WITHIN THE PATIENT. REVISION SURGERY WAS PERFORMED ON (B)(6) 2010, TO REMOVE THE TRIAL POST.

Description of Event or Problem · 1

IT WAS REPORTED PATIENT UNDERWENT TOTAL KNEE ARTHROPLASTY ON (B)(6) 2010. SUBSEQUENTLY, AT ONE MONTH POST-OPERATIVE RADIOGRAPHS, SURGEON NOTED THAT THE TIBIAL TRIAL POST WAS IMPLANTED WITHIN THE PATIENT. REVISION SURGERY WAS PERFORMED ON (B)(6) 2010, TO REMOVE THE TRIAL POST.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VANGUARD PS TIBIAL TRIAL POST DEVICE, PROSTHESIS, ALIGNMENT IQO BIOMET ORTHOPEDICS N/A UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 75 YR Hospitalization| R