FDA Adverse Event Injury Summary report: N

OXF ANATOMIC BRG RT SM SIZE 4

MDR report key: 3091252 · Received May 3, 2013

Report

Report Number
0001825034-2013-01243
Event Type
Injury
Date Received
May 3, 2013
Date of Event
April 1, 2013
Report Date
April 3, 2013
Manufacturer
BIOMET ORTHOPEDICS
Product Code
NRA
PMA / PMN Number
PP010014
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. REVIEW OF DEVICE HISTORY RECORDS SHOW THAT LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION.

Description of Event or Problem · 1

IT WAS REPORTED PATIENT UNDERWENT PARTIAL KNEE PROCEDURE (B)(6) 2009. A SUBSEQUENT REVISION TO A TOTAL KNEE WAS PERFORMED (B)(6) 2013, DUE TO INSTABILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
194255 OXF ANATOMIC BRG RT SM SIZE 4 PROSTHESIS, KNEE NRA BIOMET ORTHOPEDICS N/A 1431534

Patients

Seq Age Sex Outcome Treatment
1 Life Threatening| R