FDA Adverse Event Injury Summary report: N

VANGUARD CR POR FMRL-LT 60

MDR report key: 3120829 · Received May 20, 2013

Report

Report Number
0001825034-2013-01570
Event Type
Injury
Date Received
May 20, 2013
Date of Event
April 15, 2013
Report Date
April 22, 2013
Manufacturer
BIOMET ORTHOPEDICS
Product Code
MBH
PMA / PMN Number
PK033489
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, 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. THERE ARE WARNINGS IN THE PACKAGE INSERT THAT STATE THAT THIS TYPE OF EVENT CAN OCCUR: UNDER POSSIBLE ADVERSE EFFECTS, NUMBER 2 STATES, "EARLY OR LATE POSTOPERATIVE INFECTION AND ALLERGIC REACTION." REVIEW OF STERILIZATION CERTIFICATION CONFIRMS DEVICE WAS STERILIZED IN ACCORDANCE WITH ISO 11137-2. THIS REPORT IS NUMBER 3 OF 4 MDRS FILED FOR THE SAME EVENT (REFERENCE 1825034-2013-01568 / 01571).

Description of Event or Problem · 1

IT WAS REPORTED PATIENT UNDERWENT A TOTAL KNEE ARTHROPLASTY ON (B)(6) 2011. SUBSEQUENTLY, PATIENT WAS REVISED ON (B)(6) 2013 DUE TO INFECTION. ALL BIOMET PRODUCT WAS REMOVED AND REPLACED WITH ANTIBIOTIC SPACERS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
222808 VANGUARD CR POR FMRL-LT 60 PROSTHESIS, KNEE MBH BIOMET ORTHOPEDICS N/A 329320

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R