FDA Adverse Event Injury Summary report: N

UNKNOWN KNEE

MDR report key: 3771253 · Received April 24, 2014

Report

Report Number
0001825034-2014-03188
Event Type
Injury
Date Received
April 24, 2014
Report Date
March 26, 2014
Manufacturer
BIOMET ORTHOPEDICS
Product Code
JWH
PMA / PMN Number
PUNKNOWN
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT IDENTIFICATION NECESSARY TO REVIEW MANUFACTURING HISTORY WAS NOT PROVIDED. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. THE FOLLOWING SECTIONS COULD NOT BE COMPLETED WITH THE LIMITED INFORMATION PROVIDED. EXPIRATION DATE - UNKNOWN. DATE IMPLANTED - UNKNOWN. PMA/510(K) NUMBER - UNKNOWN. MANUFACTURE DATE ¿ UNKNOWN.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT A KNEE ARTHROPLASTY ON AN UNKNOWN DATE. A REVISION PROCEDURE HAS BEEN INDICATED; HOWEVER, THERE HAS BEEN NO REPORTED REVISION PROCEDURE TO DATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
249908 UNKNOWN KNEE PROSTHESIS, KNEE JWH BIOMET ORTHOPEDICS N/A UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R