FDA Adverse Event Injury Summary report: N

VNGD SSK 360 R FEM 75MM

MDR report key: 21431868 · Received February 21, 2025

Report

Report Number
0001825034-2025-00410
Event Type
Injury
Date Received
February 21, 2025
Date of Event
January 8, 2024
Report Date
July 31, 2025
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
K093293
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10-MEDICAL PRODUCT BMT SMOOTH KNEE STEM 18X80 ITEM# 145028, LOT# 136580. VG 360 DST FM AG 75X5 LL/RM ITEM# 185328, LOT# 765410. VG 360 DST FM AG 75X10 RL/LM ITEM# 185388, LOT# 966850. VG 360 UNIV PST FM AUG 75X5 ITEM# 185348, LOT# 665610. BMT 360 TIB TRAY 71MM ITEM# 185203, LOT# 925800. BIOMET SMOOTH KNEE STEMS 14X40 ITEM# 145004, LOT# 608190. G2- UNITED KINGDOM. H3- CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. UPDATED: A2, B4, B5, B7, D2, G1, G3, G6, H1, H2, AND H11 A2- PATIENT WAS BORN IN 1934.

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUBMITTED TO PROVIDE ADDITIONAL INFORMATION. UPDATED: B4, B5, D2, D4, G1, G3, G6, H1, H2, H3, H4, H6, AND H11. NO PRODUCT OR PHOTOS WERE RETURNED; THEREFORE, VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. REVIEW OF PRIMARY NOTES STATE NO INTRA OPERATIVE COMPLICATIONS. POST OP PATIENT WAS DETECTED WITH BREAST CANCER AND WAS EXPERIENCING PAIN, SWELLING, AND DIFFICULTY WALKING. THE PATIENT FELL AND EXPERIENCED A FEMORAL HEAD FRACTURE AND LATER EXPERIENCED A SECOND FALL AND THEN HAD TO UNDERGO AMPUTATION. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO RELATED DEVIATIONS OR ANOMALIES DURING MANUFACTURING. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. THIS COMPLAINT IS CONFIRMED VIA THE PROVIDED MEDICAL NOTES. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS. PROPOSED ANNEX G CODE: MECHANICAL (G04): FEMUR.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT'S LEG WAS AMPUTATED ABOVE THE RIGHT KNEE APPROXIMATELY NINE AND A HALF YEARS POST IMPLANTATION DUE TO INJURIES SUSTAINED IN A FALL RESULTING IN A FRACTURE OF THE RIGHT FEMUR. ATTEMPTS TO OBTAIN ADDITIONAL INFORMATION HAVE BEEN MADE; HOWEVER, NO MORE INFORMATION IS AVAILABLE AT THIS TIME.

Description of Event or Problem · 0

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

Description of Event or Problem · 0

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1045017 VNGD SSK 360 R FEM 75MM PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. 2794979

Patients

Seq Age Sex Outcome Treatment
1 80 YR Female Hospitalization| R SEE H11