FDA Adverse Event Injury Summary report: N

UNKNOWN BIGLIANI/FLATOW GLENOID

MDR report key: 5488867 · Received March 9, 2016

Report

Report Number
1822565-2016-00613
Event Type
Injury
Date Received
March 9, 2016
Report Date
February 15, 2016
Manufacturer
ZIMMER INC
Product Code
KWR
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

NO DEVICE OR PHOTOS WERE RECEIVED; THEREFORE THE CONDITION OF THE COMPONENT IS UNKNOWN. DEVICE HISTORY RECORDS CANNOT BE REVIEWED SINCE THE PART AND LOT NUMBER IS UNKNOWN. THIS DEVICE IS USED FOR TREATMENT. SURGICAL NOTES WERE NOT PROVIDED; IT IS UNKNOWN WHETHER THE COMPONENTS WERE IMPLANTED WITH THE CORRECT FIT AND ORIENTATION AS PER THE SURGICAL TECHNIQUE. PRODUCT HISTORY SEARCH CANNOT BE COMPLETED AND COMPATIBLY CANNOT BE VERIFIED SINCE THE PART AND LOT NUMBER IS UNKNOWN. PATIENT¿S ADHERENCE TO REHABILITATION PROTOCOL IS UNKNOWN. A DEFINITE ROOT CAUSE CANNOT BE DETERMINED WITH THE INFORMATION PROVIDED.

Additional Manufacturer Narrative · 1

INFORMATION WAS RECEIVED VIA PUBLISHED LITERATURE. PLEASE REFERENCE LITERATURE AT THE FOLLOWING LOCATION: HTTP://WWW.JSHOULDERELBOW.ORG/ARTICLE/S1058-2746(12)00182-6/PDF.(B)(4).THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT IS REPORTED THAT ONE PATIENT EXPERIENCED A FRACTURE OF THEIR POSTERIOR CORTEX OF THE GLENOID INTRAOPERATIVELY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
145169 UNKNOWN BIGLIANI/FLATOW GLENOID SHOULDER PROSTHESIS KWR ZIMMER INC

Patients

Seq Age Sex Outcome Treatment
1 Other