FDA Adverse Event Injury Summary report: N

VANGUARD CR ILOK FEM-RT 62.5

MDR report key: 23933798 · Received December 31, 2025

Report

Report Number
0001825034-2025-04243
Event Type
Injury
Date Received
December 31, 2025
Date of Event
December 31, 2025
Report Date
April 17, 2026
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
UDI-DI
00880304270398
PMA / PMN Number
K171054
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10- MEDICAL PRODUCT. VNGD CR TIB BRG 10X63/67, ITEM# 183420, LOT# 911740, BIOMET ILOK PRI TIB TRAY 67MM, ITEM# 141212, LOT# 982290, SERIES A PAT STD 31 3 PEG, ITEM# 184764, LOT# 833420, BIOMET FINNED PRI STEM 40MM, ITEM# 141314, LOT# 138020. H3- CUSTOMER HAS INDICATED THAT THE PRODUCT WILL 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. PROPOSED ANNEX G CODE: MECHANICAL (G04) ¿ FEMUR.

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUBMITTED TO PROVIDE ADDITIONAL INFORMATION. UPDATED: B3, B4, B5, B7, D2B, D4, D6A, D9, G1, G3, G6, H1, H2, H3, H4, H6, AND H11. D6A. INITIAL SURGERY: (B)(6) 2018. VISUAL EXAMINATION OF THE RETURNED FEMORAL DEVICE IDENTIFIED SIGNS OF USE WITH GOUGES, BONE CEMENT AND BIO-DEBRIS PRESENT. THE DEVICE WAS ALSO WORN FROM CONTACT WITH THE TIBIAL COMPONENT. SEM ANALYSIS OF THE RETURNED COMPONENTS IDENTIFIED A CORRESPONDING MARK ON THE FEMORAL COMPONENT LIKELY DUE TO PROLONGED ARTICULATION OF THE FEMORAL COMPONENT AGAINST THE TIBIAL TRAY. THERE WAS ALSO A SIMILAR MARK ON THE OPPOSITE SIDE OF THE FEMORAL COMPONENT BUT WITH NO SIMILAR VISIBLE DAMAGE TO THE TIBIAL TRAY. DIMENSIONAL ANALYSIS OF THE PRODUCT DETERMINED THAT THE PRODUCT, WHERE MEASURED, WAS CONFORMING TO PRINT SPECIFICATIONS. MEDICAL RECORDS WERE NOT PROVIDED. 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 WAS REVISED APPROXIMATELY SEVEN YEARS SEVEN AND A HALF MONTHS POST IMPLANTATION DUE TO COLLAPSE OF THE IMPLANT ON ONE SIDE CAUSING PAIN. ATTEMPTS TO OBTAIN ADDITIONAL INFORMATION HAVE BEEN MADE; HOWEVER, NO MORE INFORMATION IS AVAILABLE AT THIS TIME.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT WAS REVISED APPROXIMATELY SEVEN YEARS SEVEN AND A HALF MONTHS POST IMPLANTATION DUE TO COLLAPSE OF THE IMPLANT ON ONE SIDE CAUSING PAIN. THE PATIENT EXPERIENCED PAIN WHEN BEARING WEIGHT ON THE OPERATIVE KNEE, PAIN WHEN WALKING, INABILITY TO CLIMB OR DESCEND STAIRS DUE TO SIGNIFICANT PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2792670 VANGUARD CR ILOK FEM-RT 62.5 PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. J6178746 00880304270398

Patients

Seq Age Sex Outcome Treatment
1 NA Female Required Intervention| H SEE H11.