FDA Adverse Event Injury Summary report: N

OXF PKS ANAT MEN BRG UHMWPE LT SML SZ 4

MDR report key: 3890225 · Received June 24, 2014

Report

Report Number
3002806535-2014-00155
Event Type
Injury
Date Received
June 24, 2014
Date of Event
May 20, 2014
Report Date
May 30, 2014
Manufacturer
BIOMET UK LTD.
Product Code
NRA
PMA / PMN Number
PP010014
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE USER FACILITY IS OUTSIDE OF THE UNITED STATES. NO MEDWATCH REPORT WAS RECEIVED. NO PRODUCT WAS RETURNED. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. NO FURTHER COMPLICATIONS HAVE BEEN REPORTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT KNEE SURGERY ON (B)(6) 2012. REVISION PROCEDURE WAS PERFORMED ON (B)(6) 2014 DUE TO DISLOCATION. NO FURTHER INFORMATION HAS BEEN REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
369200 OXF PKS ANAT MEN BRG UHMWPE LT SML SZ 4 PROSTHESIS, KNEE NRA BIOMET UK LTD. N/A 2580049

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R