FDA Adverse Event Injury Summary report: N

REDUCED SIZE ONCOLOGY SALVAGE SYSTEM - AXLE

MDR report key: 6752951 · Received July 29, 2017

Report

Report Number
0001825034-2017-05302
Event Type
Injury
Date Received
July 29, 2017
Date of Event
July 19, 2017
Report Date
August 30, 2018
Manufacturer
BIOMET ORTHOPEDICS
Product Code
KRO
PMA / PMN Number
PK021260
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 1

(B)(6). (B)(4). CONCOMITANT PRODUCTS ¿ OSS RS 18MM TIBIAL BEARING CATALOG 161097 LOT 913460; OSS TIBIAL YOKE CATALOG 150493 LOT 582320; OSS POLY TIBIAL BUSHING CATALOG 150476 LOT 889990; UNKNOWN OSS TIBIAL BASEPLATE; OSS POLY LOCK PIN CATALOG 150478 LOT 710100; OSS 21CM DIAPHYSEAL SEGMENT CATALOG 150473 LOT 890180; OSS RS POLY FEMORAL BUSHINGS CATALOG 161034 LOT 746770; OSS RS 8.5CM SEG FMRL RIGHT CATALOG 161123 LOT 965270. 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: 1825034-2017-03108, 1825034-2017-05298, 1825034-2017-05258, 1825034-2017-05259, 1825034-2017-05299, 1825034-2017-05300, 1825034-2017-05301, 1825034-2017-05302, 1825034-2017-05303.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT A RIGHT KNEE REVISION APPROXIMATELY THREE MONTHS POST IMPLANTATION DUE TO QUADRICEPS DEFICIENCY. THE PATIENT WAS ALSO REPORTED AS EXPERIENCING DISLOCATION AND DISASSOCIATION. 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
533246 REDUCED SIZE ONCOLOGY SALVAGE SYSTEM - AXLE PROSTHESIS, KNEE KRO BIOMET ORTHOPEDICS N/A 274510

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R