FDA Adverse Event Injury Summary report: N

OXF ANATOMIC BEARING RT MD SIZE 4

MDR report key: 3785215 · Received May 1, 2014

Report

Report Number
0001825034-2014-03463
Event Type
Injury
Date Received
May 1, 2014
Date of Event
April 1, 2014
Report Date
June 16, 2014
Manufacturer
BIOMET U.K. LTD
Product Code
NRA
PMA / PMN Number
PP010014
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, 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. THIS REPORT IS NUMBER 1 OF 3 MDRS FILED FOR THE SAME EVENT (REFERENCE 1825034-2014-03463 / 03465).

Additional Manufacturer Narrative · 1

EVALUATION OF RETURNED DEVICE FOUND IMPLANT TO BE OUT OF DESIGN SPECIFICATIONS. A DIMENSIONAL LAYOUT REVEALED THE COMPONENT WAS OVERSIZED IN THICKNESS. HOWEVER, THE OVERSIZED DIMENSIONS WOULD HAVE PROVIDED MORE STABILITY.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT A PARTIAL RIGHT KNEE ARTHROPLASTY ON (B)(6) 2013. SUBSEQUENTLY, PATIENT UNDERWENT A REVISION PROCEDURE ON (B)(6) 2014, FOR AN UNKNOWN REASON. ALL OXFORD PARTIAL KNEE COMPONENTS WERE REMOVED AND REPLACED WITH VANGUARD TOTAL KNEE COMPONENTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
262036 OXF ANATOMIC BEARING RT MD SIZE 4 PROSTHESIS, KNEE NRA BIOMET U.K. LTD N/A 2919979

Patients

Seq Age Sex Outcome Treatment
1 73 YR Hospitalization| R