FDA Adverse Event Injury Summary report: N

NATURAL-KNEE FLEX PROLONG ARTICULAR SURFACE

MDR report key: 2960291 · Received February 8, 2013

Report

Report Number
1822565-2013-00267
Event Type
Injury
Date Received
February 8, 2013
Date of Event
September 13, 2011
Report Date
January 9, 2013
Manufacturer
ZIMMER, INC.
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: SURGICAL NOTES WERE PROVIDED AND REVIEWED. THE SURGEON NOTED THAT THE PT SUSTAINED A SEVERE FALL CAUSING THE ARTICULAR SURFACE TO DISLODGE. IT WAS NOTED THAT A GENDER SPECIFIC FEMALE NATURAL KNEE SIZE 2 FEMORAL COMPONENT WAS USED WITH THE DEVICE, WHICH IS A SIZE 00/0. THIS WOULD BE CONSIDERED AN OFF-LABEL USE OF THIS PRODUCT AS INDICATED ON THE SURGICAL TECHNIQUE. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED WITH THE INFORMATION PROVIDED. HOWEVER, THE COMPLAINT MAY BE REVISED UPON RETURN OF X-RAYS AND/OR FURTHER INFORMATION. THE DHR HAS BEEN REVIEWED AND THE LOT IN QUESTION WAS PRODUCED, INSPECTED AND PACKAGED WITHIN ESTABLISHED AND VALIDATED PROCESS PARAMETERS. THE DEVICE WAS RECEIVED AND EVALUATED BOTH VISUALLY AND DIMENSIONALLY. DEFORMATIONS AND GOUGES WERE NOTED ON THE INFERIOR SURFACE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PT WAS REVISED DUE TO PAIN CAUSED BY A DISLOCATED ARTICULAR SURFACE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
54252 NATURAL-KNEE FLEX PROLONG ARTICULAR SURFACE JWH ZIMMER, INC. 60853868

Patients

Seq Age Sex Outcome Treatment
1 59 YR Required Intervention