FDA Adverse Event Injury Summary report: N

50MM LFT STANDARD MAND

MDR report key: 2143336 · Received June 29, 2011

Report

Report Number
1032347-2011-00092
Event Type
Injury
Date Received
June 29, 2011
Date of Event
November 2, 2010
Report Date
June 2, 2011
Manufacturer
BIOMET MICROFIXATION
Product Code
LZD
PMA / PMN Number
P020016
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PER THE DOCTOR'S COMMENT, THERE WAS NOT AN ISSUE ON THE DEVICE NOT FUNCTIONING CORRECTLY, BUT THE ISSUE WAS THE SIZE OF IMPLANT SELECTED AND USED WAS TOO LARGE FOR THE PATIENT. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A VALID CONCLUSION ABOUT THE CAUSE OF THIS EVENT. IF ADDITIONAL INFORMATION IS OBTAINED THAT ADDS VALUE TO THE RELEVANT CONTENT OF THIS REPORT AND/OR A CONCLUSION CAN BE DRAWN, A FOLLOW-UP REPORT WILL BE SENT. THE DOCTOR WHO IMPLANTED THE DEVICES IS NOT THE SAME DOCTOR WHO EXPLANTED. IMPLANTED BY: DR. (B)(6) AT (B)(6). EXPLANTED BY: DR. (B)(6). THERE WERE 4 DEVICES EXPLANTED, SEE MDRS 1032347-2011-00091 TO 00094.

Description of Event or Problem · 1

IT WAS REPORTED THE PATIENT HAD BILATERAL TMJ REPLACEMENT ON (B)(6) 2009. THE DEVICES WERE EXPLANTED ON (B)(6) 2010 DUE TO THEM NOT FITTING PROPERLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 50MM LFT STANDARD MAND TMJ LZD BIOMET MICROFIXATION 826750

Patients

Seq Age Sex Outcome Treatment
1 25 YR Hospitalization