FDA Adverse Event Injury Summary report: N

VANGUARD TIBIAL BEARING

MDR report key: 2092729 · Received May 10, 2011

Report

Report Number
3002806535-2011-00062
Event Type
Injury
Date Received
May 10, 2011
Date of Event
December 8, 2008
Report Date
April 11, 2011
Manufacturer
BIOMET UK LTD.
Product Code
JWH
PMA / PMN Number
K080528
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE USER FACILITY IS OUTSIDE OF THE UNITED STATES. NO MEDWATCH REPORT WAS REC'D. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. NO FURTHER COMPLICATIONS HAVE BEEN REPORTED. THIS REPORT FILED (B)(4), 2011.

Description of Event or Problem · 1

IT WAS REPORTED THAT PT UNDERWENT KNEE PROCEDURE ON (B)(6), 2008. PT UNDERWENT REVISION SURGERY ON (B)(6), 2008 DUE TO PAIN AND INSTABILITY. NO FURTHER COMPLICATIONS HAVE BEEN REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VANGUARD TIBIAL BEARING JWH BIOMET UK LTD. NA 1162711

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R