FDA Adverse Event Injury Summary report: N

OSS FEMORAL BUSHINGS

MDR report key: 6549727 · Received May 5, 2017

Report

Report Number
0001825034-2017-03135
Event Type
Injury
Date Received
May 5, 2017
Date of Event
May 18, 2015
Report Date
October 31, 2017
Manufacturer
BIOMET ORTHOPEDICS
Product Code
JDI
PMA / PMN Number
PK002757
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: OSS POROUS COATED IM STEM W/SCREW - 11.5 MM X 90 MM, ITEM #: 150382, LOT #: 339930. OSS SEGMENTAL FEMORAL - LEFT 7 CM, ITEM #: 150355, LOT #: 190480. OSS POROUS COATED BOWED IM STEM W/SCREW, ITEM #: 150402, LOT #: 249770. OSS-K DIAPHYSEAL SEGMENT 4CM W/SCREWS, ITEM #: CP111275, LOT #: 011040. OSS POROUS COATED BOWED IM STEM W/SCREW, ITEM #: 150403, LOT #: 614490. OSS 16MM TIBIAL BEARING, ITEM #: 150412, LOT #: 485450. OSS-K 67 MM MODULAR POROUS COATED W/PLUG TIBIAL BASE, ITEM #: CP102513, LOT #: 684410. OSS TIBIAL BUSHING, ITEM #: 150476, LOT #: 337250. OSS AXLE, ITEM #: 150480, LOT #: 193670. OSS LOCKING PIN, ITEM #: 150478, LOT #: 823670. OSS TM YOKE, ITEM #: 150493, LOT #: 190730. CUSTOMER HAS NOT INDICATED THAT THE PRODUCT WILL BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. CURRENT LOCATION OF THE PRODUCT IS UNKNOWN. 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: 0001825034-2017-03140, 0001825034-2017-03127, 0001825034-2017-03129, 0001825034-2017-03130, 0001825034-2017-03131, 0001825034-2017-03132, 0001825034-2017-03133, 0001825034-2017-03134, 0001825034-2017-03136, 0001825034-2017-03138, AND 0001825034-2017-03139.

Additional Manufacturer Narrative · 1

UPON RECEIVING ADDITIONAL INFORMATION ON THE REPORTED EVENT, IT WAS DETERMINED TO BE NOT REPORTABLE AS ONLY THE PATIENT'S YOKE WAS REPLACED DUE TO A FRACTURE.

Description of Event or Problem · 1

IT WAS REPORTED THAT FOLLOWING A TOTAL KNEE ARTHROPLASTY, THE PATIENT WAS REVISED DUE TO UNKNOWN REASONS. 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
329353 OSS FEMORAL BUSHINGS PROSTHESIS, HIP JDI BIOMET ORTHOPEDICS 381710 

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R