FDA Adverse Event Injury Summary report: N

NEXGEN LPS FEMORAL COMPONENT

MDR report key: 2516409 · Received March 29, 2012

Report

Report Number
1822565-2012-00620
Event Type
Injury
Date Received
March 29, 2012
Date of Event
October 15, 2009
Report Date
February 28, 2012
Manufacturer
ZIMMER INC
Product Code
NJL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: NEITHER SURGICAL NOTES NOR X-RAYS WERE PROVIDED, THEREFORE FIT AND ORIENTATION COULD NOT BE EVALUATED. PT FACTORS THAT MAY AFFECT THE PERFORMANCE OF THE COMPONENTS SUCH AS BONE QUALITY, ACTIVITY LEVEL OR TYPE OF ACTIVITY (LOW IMPACT VS. HIGH IMPACT) ARE UNK. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED WITH THE INFO PROVIDED. EVALUATION: REVIEW OF THE DEVICE HISTORY RECORDS DID NOT FIND ANY DEVIATIONS OR ANOMALIES. IT IS NOT SUSPECTED THAT THE PRODUCT FAILED TO MEET SPECIFICATIONS. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT CONTRIBUTION TO THE REPORTED PROBLEM. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. SHOULD ADDITIONAL SUBSTANTIVE INFO BE RECEIVED, THE COMPLAINT WILL BE REOPENED. ZIMMER, INC. CONSIDERS THE INVESTIGATION CLOSED.

Description of Event or Problem · 1

IT IS REPORTED THAT THE PT UNDERWENT A LEFT KNEE JOINT ASPIRATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NEXGEN LPS FEMORAL COMPONENT NJL ZIMMER INC 61303468

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention MFG BY ZIMMER (B)(4)| NEXGEN LPS-FLEX ARTICULAR SURFACE:| CATALOG #00598004702, LOT #61274445| CATALOG #00596404010, LOT #61281712| NEXGEN STEMMED TIBIAL COMPONENT: