FDA Adverse Event Injury Summary report: N

OXF UNI C/LESS TIB TRAY RM C

MDR report key: 5718935 · Received June 10, 2016

Report

Report Number
3002806535-2016-00351
Event Type
Injury
Date Received
June 10, 2016
Report Date
May 11, 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 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. REMAINS IMPLANTED.

Description of Event or Problem · 1

PATIENT UNDERWENT UNKNOWN CONSERVATIVE TREATMENT DUE TO A TIBIA FRACTURE WHICH OCCURRED APPROXIMATELY THIRTEEN DAYS POST-IMPLANTATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
371929 OXF UNI C/LESS TIB TRAY RM C PROSTHESIS, KNEE NRA BIOMET UK LTD. N/A NI

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R