FDA Adverse Event Injury Summary report: N

ASCENT SYSTEM - FEMORAL

MDR report key: 6513121 · Received April 21, 2017

Report

Report Number
0001825034-2017-02731
Event Type
Injury
Date Received
April 21, 2017
Report Date
July 29, 2017
Manufacturer
BIOMET ORTHOPEDICS
Product Code
JWH
PMA / PMN Number
PK982869
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). MEDICAL PRODUCT-BIOMET CC CRUCIATE TRAY 83MM CATALOG# 141236 LOT# 715600, ASCENT PRI LIP BRG 10X79/83 CATALOG# 179330 LOT# 772410, BMET ARCOM AP PAT 3PST 34MM MD CATALOG# 11-150842 LOT# 596640. IT IS UNKNOWN IF PRODUCT WILL BE RETURNING TO ZIMMER BIOMET AND 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 - 02689, 0001825034 - 2017 - 02728, 0001825034 - 2017 - 02729 , 0001825034 - 2017 - 02731.

Additional Manufacturer Narrative · 1

UPON RECEIPT OF ADDITIONAL INFORMATION IT HAS BEEN DETERMINED THAT THIS DEVICE DID NOT CAUSE OR CONTRIBUTE TO THE REPORTED EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT MAY REQUIRE A REVISION PROCEDURE DUE TO UNKNOWN REASONS. HOWEVER, NO REVISION HAS BEEN REPORTED TO DATE. 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
293405 ASCENT SYSTEM - FEMORAL PROSTHESIS, KNEE JWH BIOMET ORTHOPEDICS 704930

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention