FDA Adverse Event Injury Summary report: N

NEXGEN LPS-FLEX ARTICULAR SURFACE

MDR report key: 5754648 · Received June 28, 2016

Report

Report Number
0001822565-2016-02195
Event Type
Injury
Date Received
June 28, 2016
Report Date
February 2, 2017
Manufacturer
ZIMMER, INC.
Product Code
MBH
PMA / PMN Number
PK042271
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Additional Manufacturer Narrative · 1

CONCOMITANT MEDICAL PRODUCTS: ZIMMER NEXGEN FEMORAL COMPONENT, CATALOG #: 00-5996-015-52, LOT #: 62976890. ZIMMER NEXGEN TIBIAL COMPONENT, CATALOG #: 00-5980-037-02, LOT #: 62928171. ZIMMER PERSONA PATELLA CATALOG #: 42-5400-000-35, LOT #: 62869346. THIS FOLLOW-UP REPORT IS BEING FILED TO RELAY ADDITIONAL INFORMATION, WHICH WAS UNKNOWN AT THE TIME OF THE INITIAL MEDWATCH. THIS IS REPORT 3 OF 4 FOR THIS PATIENT. SEE ALSO 3007963827-2016-00047-2, 0002648920-2016-00905-2, AND 0002648920-2016-00906-2. NO DEVICES WERE RECEIVED; THEREFORE THE CONDITION OF THE COMPONENTS IS UNKNOWN. REVIEW OF THE DEVICE HISTORY RECORDS FOR THE FEMORAL COMPONENT, ARTICULAR SURFACE, AND PATELLAR COMPONENT IDENTIFIED NO DEVIATIONS OR ANOMALIES. REVIEW OF THE DEVICE HISTORY RECORDS FOR THE TIBIAL COMPONENT IDENTIFIED ONE ANOMALY DUE TO A UNIT BEING FOUND OVERSIZED IN OPERATION 100 (MACHINE COMPLETE AND DEBURR). THE AFFECTED UNIT WAS SCRAPPED DUE TO THE THREAD BEING OUT OF SPECIFICATION. THIS ANOMALY WOULD NOT HAVE CAUSED OR CONTRIBUTED TO THE REPORTED EVENT. THE TIBIAL COMPONENT ALSO HAD A DEVIATION DUE TO A WATER PIPE BREAK AT THE PONCE FACILITY, WHICH CAUSED THE CLEAN ROOM PARAMETERS TO BE OUT OF THE ESTABLISHED RANGES. AS A RESULT, THIS LOT WAS REWORKED WITH ADDED OPERATIONS AFTER OPERATION 2500 TO REPLACE THE POLY SUBCOMPONENTS AND INSPECT. THE LOT PROCEEDED THROUGH NORMAL PROCESSING AFTER THE REWORK. THIS DEVIATION WOULD NOT HAVE CAUSED OR CONTRIBUTED TO THE REPORTED EVENT. 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. REVIEW OF THE IMPLANTED DEVICES IDENTIFIED NO COMPATIBILITY ISSUES. SINGLE-USE, STERILIZED DEVICES MANUFACTURED OR DISTRIBUTED BY ZIMMER ARE STERILIZED IN ACCORDANCE WITH FDA REGULATIONS AND ISO STANDARDS TO A STERILITY ASSURANCE LEVEL OF 1.0 X 10-6 OR BETTER. THEREFORE, IT IS HIGHLY UNLIKELY THAT THE SPECIFIED DEVICE CAUSED ANY PATIENT INFECTION. PER THE NEXGEN CR, PS, CRA, LPS, AND LCCK PACKAGE INSERT, SWELLING OR INFECTION ARE KNOWN RISKS OF THIS PROCEDURE. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED WITH THE INFORMATION PROVIDED.

Additional Manufacturer Narrative · 1

(B)(4). THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT IS FURTHER REPORTED THAT THE PATIENT UNDERWENT TWO ADDITIONAL PROCEDURES FOR DRAINAGE OF THE SURGICAL SITE, REMOVAL OF SCAR TISSUE, AND MANIPULATION OF THE IMPLANTED DEVICES.

Description of Event or Problem · 1

IT IS REPORTED THAT THE PATIENT IS EXPERIENCING PAIN, STIFFNESS, INFECTION, LIMITED RANGE OF MOTION, LIMPING AND NOISE FROM THE IMPLANT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
409121 NEXGEN LPS-FLEX ARTICULAR SURFACE KNEE PROSTHESIS MBH ZIMMER, INC. 62247472

Patients

Seq Age Sex Outcome Treatment
1 Other| R