FDA Adverse Event Injury Summary report: N

VANGUARD COMPLETE KNEE SYSTEM- PS CLSD INTLK FEM-RT 67.5

MDR report key: 6501008 · Received April 18, 2017

Report

Report Number
0001825034-2017-02633
Event Type
Injury
Date Received
April 18, 2017
Report Date
September 26, 2017
Manufacturer
BIOMET ORTHOPEDICS
Product Code
JWH
PMA / PMN Number
PK113550
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: ITEM: COCR I-BEAM TRAY 67MM, CATALOG NUMBER: 141222, LOT: J3872064, ITEM: SERIES A PATELLA 28MM, CATALOG NUMBER: 184762, LOT: 273320, ITEM: VANGUARD PS TIBIAL BEARING, CATALOG NUMBER: 183620, LOT: 141380. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED AS IT REMAINS IMPLANTED 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: 0001825034-2017-02634/02635/02636. ZIMMER BIOMET REFERENCE NUMBER: (B)(4).

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION.

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. DEVICE HISTORY RECORD WAS REVIEWED AND NO DISCREPANCIES 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 AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. THERE ARE WARNINGS IN THE PACKAGE INSERT THAT THIS TYPE OF EVENT CAN OCCUR AND RISKS ARE ADDRESSED IN RISK DOCUMENTATION. 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.

Description of Event or Problem · 1

IT WAS REPORTED A PATIENT WHO UNDERWENT A TOTAL KNEE ARTHROPLASTY APPROXIMATELY SIX MONTHS AGO HAS BEEN BEEN EXPERIENCING PAIN IN THE HIP, LEG, AND GROIN ALONG WITH STIFFNESS. NO REVISION HAS BEEN REPORTED TO DATE.

Description of Event or Problem · 1

IT WAS REPORTED A PATIENT WHO UNDERWENT A TOTAL KNEE ARTHROPLASTY APPROXIMATELY SIX MONTHS AGO HAS BEEN BEEN EXPERIENCING PAIN IN THE HIP, LEG, AND GROIN ALONG WITH STIFFNESS. NO REVISION HAS BEEN REPORTED TO DATE. ADDITIONAL INFORMATION RECEIVED INDICATES THE PATIENT WAS ALSO EXPERIENCING SWELLING AND WARM TO THE TOUCH ON HIS KNEE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
282653 VANGUARD COMPLETE KNEE SYSTEM- PS CLSD INTLK FEM-RT 67.5 PROSTHESIS, KNEE JWH BIOMET ORTHOPEDICS 752790

Patients

Seq Age Sex Outcome Treatment
1 Other| R