FDA Adverse Event Injury Summary report: N

OXFORD PKS CEMENTLESS TIB COCR SIZE A LM

MDR report key: 5664666 · Received May 18, 2016

Report

Report Number
3002806535-2016-00275
Event Type
Injury
Date Received
May 18, 2016
Report Date
June 1, 2016
Manufacturer
BIOMET UK LTD.
Product Code
NRA
PMA / PMN Number
PN/A
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS FOLLOW UP REPORT IS BEING FILED TO RELAY ADDITIONAL PRODUCT INFORMATION THAT WAS UNKNOWN AT THE TIME OF THE INITIAL MEDWATCH.

Additional Manufacturer Narrative · 1

THIS USER FACILITY IS OUTSIDE OF THE UNITED STATES. 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. THIS PRODUCT IS MANUFACTURED BY ZIMMER BIOMET (B)(4) AND IS NOT CLEARED OR DISTRIBUTED IN THE U.S. HOWEVER, THIS REPORT IS BEING SUBMITTED AS ZIMMER BIOMET IN (B)(4) MANUFACTURES A SIMILAR DEVICE IN THE UNITED STATES UNDER PMA NUMBER P010014. PRODUCT LOCATION UNKNOWN.

Description of Event or Problem · 1

PATIENT UNDERWENT UNKNOWN CONSERVATIVE TREATMENT DUE TO TIBIA FRACTURE WHICH OCCURRED APPROXIMATELY ONE MONTH POST-IMPLANTATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
318230 OXFORD PKS CEMENTLESS TIB COCR SIZE A LM PROSTHESIS, KNEE NRA BIOMET UK LTD. N/A 3575272

Patients

Seq Age Sex Outcome Treatment
1 70 YR Other