FDA Adverse Event Injury Summary report: N

ARTICULAR SURFACE (MC) RIGHT 10 MM HEIGHT

MDR report key: 22131030 · Received June 3, 2025

Report

Report Number
3007963827-2025-00224
Event Type
Injury
Date Received
June 3, 2025
Date of Event
July 23, 2024
Report Date
October 23, 2025
Manufacturer
ZIMMER ORTHOPAEDIC MFG. LTD.
Product Code
MBH
UDI-DI
00889024468092
PMA / PMN Number
K150090
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10-MEDICAL PRODUCT: TIBIA CEMENTED 5 DEGREE STEMMED RIGHT SIZE C, ITEM# 42532006402, LOT# 65282268. FEMUR CEMENTED (CR) STANDARD NITRIDED RIGHT SIZE 7, ITEM# 42572606202, LOT# 65148467. ALL-POLY PATELLA CEMENTED 29 MM DIAMETER, ITEM# 42540200029, LOT# 65134430. PALACOS MV 1X40 US, ITEM# 5087347, LOT# 97971007. PALACOS MV+G 1X40 US, ITEM# 5051207, LOT# 96794917. H3- CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION AS IT REMAINS IMPLANTED. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUBMITTED TO PROVIDE ADDITIONAL INFORMATION. UPDATED: B4, B5, D2, G1, G3, G6, H1, H2, H3, H6, H10, AND H11. NO PRODUCT WAS RETURNED, OR PICTURES PROVIDED; THEREFORE, VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. MEDICAL RECORDS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING: IT WAS REPORTED PROGRESSIVE/PERSISTENT MODERATE PAIN, STARTED ON MEDROL DOS PAK, AND RESOLVED. ALONG WITH WORSENING LOWER BACK PAIN (NOT RELATED TO STUDY KNEE). REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. THIS COMPLAINT IS CONFIRMED. 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT EXPERIENCED PROGRESSIVE PERSISTENT PAIN AND WAS PRESCRIBED MEDICATION APPROXIMATELY TWO YEARS AND THREE MONTHS POST IMPLANTATION. THE PATIENT WAS PRESCRIBED MEDROL DOS PAK AND THE ISSUE RESOLVED. ATTEMPTS TO OBTAIN ADDITIONAL INFORMATION HAVE BEEN MADE; HOWEVER, NO MORE INFORMATION IS AVAILABLE.

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
431652 ARTICULAR SURFACE (MC) RIGHT 10 MM HEIGHT PROSTHESIS, KNEE MBH ZIMMER ORTHOPAEDIC MFG. LTD. 63845996 00889024468092

Patients

Seq Age Sex Outcome Treatment
1 NA Female Other SEE H11.