VANGUARD PS OPEN INTL FEM RT 75
Report
- Report Number
- 0001825034-2026-00907
- Event Type
- Injury
- Date Received
- April 9, 2026
- Date of Event
- May 6, 2021
- Report Date
- April 9, 2026
- Manufacturer
- ZIMMER BIOMET, INC.
- Product Code
- JWH
- UDI-DI
- 00880304270824
- PMA / PMN Number
- K113550
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- UT, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
(B)(4). D10: MEDICAL PRODUCT: VNGD PS+ TIB BRG 10X79/83 MM: CATALOG#183760, LOT#531780; BIOMET ILOK PRI TIB TRAY 79 MM: CATALOG#141215, LOT#NI; BIOMET FINNED PRI STEM 40 MM: CATALOG#141314, LOT#NI; COBALT G-HV BONE CEMENT 40GM: CATALOG#600-15-100, LOT# NI. H6: PROPOSED COMPONENT CODE: MECHANICAL (G04) - FEMUR. THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS; HOWEVER, AN INVESTIGATION OF THE REPORTED EVENT IS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A SUPPLEMENTAL MEDWATCH 3500A WILL BE SUBMITTED.
IT WAS REPORTED BY LEGAL THAT A PATIENT HAD AN INITIAL RIGHT TOTAL KNEE ARTHROPLASTY. A FEW YEARS POSTOP, THE PATIENT REPORTEDLY STEPPED ON A BOOK WHICH BROKE APART THE IMPLANTED COMPONENTS RESULTING IN DIFFICULTY AMBULATING AND PAIN AND ALLOWED THE KNEE TO BE ROTATED INDEPENDENTLY ABOVE AND BELOW THE PROSTHESIS. SUBSEQUENTLY, THREE (3) YEARS AND SEVEN (7) MONTHS POST-IMPLANTATION, A REVISION OF UNKNOWN COMPONENTS WAS PERFORMED. ALL AVAILABLE INFORMATION HAS BEEN PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 895792 | VANGUARD PS OPEN INTL FEM RT 75 | PROSTHESIS, KNEE | JWH | ZIMMER BIOMET, INC. | 370100 | 00880304270824 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Male | Required Intervention| H | SEE H11 NARRATIVE. |