FDA Adverse Event Injury Summary report: N

BIOMET 360 TIBIAL TRAY

MDR report key: 6301751 · Received February 3, 2017

Report

Report Number
0001825034-2017-00408
Event Type
Injury
Date Received
February 3, 2017
Report Date
June 30, 2017
Manufacturer
BIOMET ORTHOPEDICS
Product Code
JWH
PMA / PMN Number
PK093293
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DHR WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. REVIEW OF THE COMPLAINT HISTORY DETERMINED THAT NO FURTHER ACTION IS REQUIRED AS NO WERE TRENDS IDENTIFIED. ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. A SUMMARY OF THE INVESTIGATION HAS BEEN SENT TO THE COMPLAINANT. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Additional Manufacturer Narrative · 1

CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. (B)(4). MEDICAL PRODUCTS - SPLINED KNEE STEM / PN 141618/ LN 883600, SMOOTH KNEE STEMS / PN 145006/ LN 035600, VANGUARD SSK / PN 185282/ LN 2597034, SERIES A STANDARD PATELLA / PN 184762/ LN 007230, TIBIAL SM CRUCIATE WING / PN 185650/ LN 056270, TIBIAL OFFSET ADAPTER / PN 185211/ LN 154920. THERAPY DATE - NI. THIS REPORT IS NUMBER 7 OF 7 MDRS FILED FOR THE SAME EVENT* (REFERENCE 0001825034-2017-00393, 0001825034-2017-00395, 0001825034-2017-00396, 0001825034-2017-00399, 0001825034-2017-00406, 0001825034-2017-00407).

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING FILED TO RELAY ADDITIONAL INFORMATION, WHICH WAS UNKNOWN AT THE TIME OF THE INITIAL MEDWATCH. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DHR WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. REVIEW OF THE COMPLAINT HISTORY DETERMINED THAT NO FURTHER ACTION IS REQUIRED AS NO TRENDS WERE IDENTIFIED. ROOT CAUSE WAS UNABLE TO BE DETERMINED. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Description of Event or Problem · 1

THE PATIENT UNDERWENT A REVISION SURGERY, BUT IT WAS REPORTED THAT THE SAME ¿DARK SPOT¿ APPEARED AFTER A SHORT PERIOD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
84730 BIOMET 360 TIBIAL TRAY PROSTHESIS, KNEE JWH BIOMET ORTHOPEDICS N/A 914440

Patients

Seq Age Sex Outcome Treatment
1 Other