FDA Adverse Event Injury Summary report: N

ONCOLOGY SALVAGE SYSTEM - FEMORAL

MDR report key: 6437072 · Received March 27, 2017

Report

Report Number
0001825034-2017-02148
Event Type
Injury
Date Received
March 27, 2017
Date of Event
March 23, 2017
Report Date
April 28, 2017
Manufacturer
BIOMET ORTHOPEDICS
Product Code
JDI
PMA / PMN Number
PK002757
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: OSS CEMENTED STEM 18MM X 150MM CATALOG 150372 LOT 085170; OSS TIBIAL BEARING 18MM CATALOG 150413 LOT 991910; OSS TIBIAL SLEEVE AUGMENT CATALOG 150455 LOT 598190; OSS LOCK PIN CATALOG 150478 LOT 610340; OSS TIBIAL BUSHING CATALOG 150476 LOT 594960; OSS 2PK FEMORAL BUSHINGS CATALOG 150477 LOT 542750; OSS AXLE CATALOG 150480 LOT 014340; OSS REINFORCED YOKE CATALOG 150493 LOT 291400; OSS 3CM NON-MODULAR PROXIMAL TIBIA 11MM X 240MM CATALOG 150805 LOT 623670. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 1825034-2017-02147.

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 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. 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

IT WAS REPORTED THAT THE PATIENT UNDERWENT A LEFT KNEE REVISION APPROXIMATELY TWO YEARS POST IMPLANTATION DUE TO FEMORAL LOOSENING. NO ADDITIONAL PATIENT CONSEQUENCES WERE REPORTED. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
218337 ONCOLOGY SALVAGE SYSTEM - FEMORAL PROSTHESIS, HIP JDI BIOMET ORTHOPEDICS 241140

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R