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 |