FDA Adverse Event Injury Summary report: N

PT HYBRID GLEN POST REGENEREX

MDR report key: 2834405 · Received November 15, 2012

Report

Report Number
0001825034-2012-02423
Event Type
Injury
Date Received
November 15, 2012
Date of Event
August 30, 2012
Report Date
October 22, 2012
Manufacturer
BIOMET ORTHOPEDICS
Product Code
KWS
PMA / PMN Number
PK060694
Removal / Correction Number
1825034-2012-019R
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

EVALUATION OF ANOTHER DEVICE CONFIRMS REPORTED COMPLAINT. INVESTIGATION INTO THE ISSUE IS ONGOING.

Additional Manufacturer Narrative · 1

DECISION WAS MADE TO RECALL BASED ON AN OPERATOR ISSUE THAT WAS DETERMINED AS PART OF AN INTERNAL INVESTIGATION. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED PATIENT UNDERWENT TOTAL SHOULDER ARTHROPLASTY ON (B)(6) 2012. DURING THE PROCEDURE, THE SURGICAL TECH ATTEMPTED TO THREAD THE REGENEREX POST TO THE HYBRID GLENOID BASE; HOWEVER, IT STOPPED APPROXIMATELY 1MM FROM SEATING. THE SURGEON ATTEMPTED TO USE AND NOTED IT WOULD NOT SEAT AS INTENDED. ANOTHER IMPLANT WAS OPENED AND USED TO FINISH THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PT HYBRID GLEN POST REGENEREX PROSTHESIS, SHOULDER KWS BIOMET ORTHOPEDICS N/A 474160

Patients

Seq Age Sex Outcome Treatment
1