FDA Adverse Event Injury Summary report: N

ONCOLOGY SALVAGE SYSTEM - TIBIAL POLY BEARING 16MM

MDR report key: 6451365 · Received March 31, 2017

Report

Report Number
0001825034-2017-02330
Event Type
Injury
Date Received
March 31, 2017
Date of Event
March 4, 2017
Report Date
January 19, 2018
Manufacturer
BIOMET ORTHOPEDICS
Product Code
JDI
PMA / PMN Number
PK002757
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. REPORTED EVENT WAS CONFIRMED BY REVIEW OF OPERATIVE NOTES. DEVICE HISTORY RECORD (DHR) WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. REVIEW OF THE COMPLAINT HISTORY DETERMINED THAT NO FURTHER ACTIONS ARE REQUIRED. INVESTIGATION RESULTS CONCLUDED THAT THE REPORTED EVENT WAS DUE TO CAUSE OF THE INFECTION IS ATTRIBUTED TO BOTH THE MANUFACTURING AND QUALITY SYSTEM ISSUE AND THE REUSE OF THE FEMORAL IMPLANT. 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. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 1825034-2017-02328, 1825034-2017- 02329, 1825034-2017-02330.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT PRODUCTS: OSS AXLE CATALOG 150480 LOT 146210. OSS REINFORCED YOKE CATALOG 150493 LOT 066340. OSS DIAPHYSEAL SEGMENTAL LOCK SCREW CATALOG 150481 LOT 935180. OSS TIBIAL AUGMENT CATALOG 150426 LOT 896800. OSS TIBIAL AUGMENT CATALOG 150426 LOT 015450. OSS SEGMENTAL FEMUR CATALOG 150355 LOT 919810. OSS IM STEM 14X150 CATALOG 150368 LOT 691040. OSS 3CM DIAPHYSEAL SEGMENTAL CATALOG 150368 LOT 691040. CUSTOMER HAS NOT INDICATED THAT THE PRODUCT WILL 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 REPORTS: 1825034-2017-02327, 1825034-2017-02328, 1825034-2017-02329.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT WAS EXPERIENCING PAIN AND EFFUSION AFTER A KNEE REVISION PROCEDURE, SUBSEQUENTLY, THE PATIENT TESTED POSITIVE FOR STAPHYLOCOCCUS AND WAS REVISED APPROXIMATELY TWO MONTHS POST IMPLANTATION. NO ADDITIONAL PATIENT CONSEQUENCES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
231263 ONCOLOGY SALVAGE SYSTEM - TIBIAL POLY BEARING 16MM PROSTHESIS, HIP JDI BIOMET ORTHOPEDICS 231210

Patients

Seq Age Sex Outcome Treatment
1 50 YR Hospitalization| R