FDA Adverse Event Injury Summary report: N

REGENEREX BIOMET PRIMARY TIBIAL TRAY 75MM WITH LOCKING BAR

MDR report key: 6308990 · Received February 7, 2017

Report

Report Number
0001825034-2017-00519
Event Type
Injury
Date Received
February 7, 2017
Date of Event
January 5, 2017
Report Date
February 7, 2017
Manufacturer
BIOMET ORTHOPEDICS
Product Code
MBH
PMA / PMN Number
PK080361
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

UPON RECEIPT OF ADDITIONAL INFORMATION THIS EVENT WILL BE REPORTED ON 1825034-2017-03697.

Additional Manufacturer Narrative · 1

CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. REVIEW OF DEVICE HISTORY RECORDS SHOW THAT LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION. BIOMET KNEE SYSTEM MODULAR FINNED STEM WITH SCREW CATALOG 141314 LOT 304970; VANGAURD KNEE SYSTEM CR FEMORAL ¿ LEFT 67.5MM CATALOG 183070 LOT 800010; VANGUARD KNEE SYSTEM AS TIBIAL BEARING 10MM 75MM CATALOG 189080 LOT 553000; BIOMET MODULAR TIBIAL LOCKING BAR CATALOG 141205 LOT 125220. THIS REPORT IS NUMBER 3 OF 6 MDRS FILED FOR THE SAME PATIENT (REFERENCE 1825034-2017-00517 / 1825034-2017-00522).

Description of Event or Problem · 1

PATIENT UNDERWENT A TOTAL KNEE REVISION DUE TO CONTINUED PAIN AND STIFFNESS 17 DAYS POST BEARING EXCHANGE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
89684 REGENEREX BIOMET PRIMARY TIBIAL TRAY 75MM WITH LOCKING BAR PROSTHESIS, KNEE MBH BIOMET ORTHOPEDICS N/A 295310

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R