VANGUARD CR FEMORAL COMPONENT
Report
- Report Number
- 0001825034-2017-05068
- Event Type
- Injury
- Date Received
- July 21, 2017
- Report Date
- September 23, 2017
- Manufacturer
- BIOMET ORTHOPEDICS
- Product Code
- JWH
- PMA / PMN Number
- PK113550
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- PHYSICIAN
Narratives
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. RISKS ASSOCIATED WITH THE REPORTED CONDITION ARE ADDRESSED THROUGH THE WARNINGS IN THE PACKAGE INSERT AS A PART OF DESIGN CONTROL RISK MANAGEMENT. 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.
PT IDENTIFIER: - (B)(6). CONCOMITANT MEDICAL PRODUCT: REGENEREX SERIES-A PATELLA 3 PEG, CAT#: 141358 LOT#: 232630. BIOMET KNEE SYSTEM MODULAR FINNED STEM WITH SCREW, CAT#: 141314 LOT#: 584160. REGENEREX PRIMARY TIBIAL TRAY WITH LOCKING BAR, CAT#: 141275 LOT#: 220440. VANGUARD TIBIAL BEARING CR LIPPED, CAT#: EP-183560 LOT#: 964280. 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: 0001825034-2017-05065, 0001825034-2017-05066, 0001825034-2017-05067, 0001825034-2017-05068, 0001825034-2017-05069. REMAINS IMPLANTED.
IT WAS REPORTED THAT THE PATIENT HAS OCCASIONAL PAIN AND CRAMPING IN THE LEFT KNEE. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 513553 | VANGUARD CR FEMORAL COMPONENT | PROSTHESIS, KNEE | JWH | BIOMET ORTHOPEDICS | 601330 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |