FDA Adverse Event Injury Summary report: N

BIOMET FINNED PRI STEM 40MM

MDR report key: 6755975 · Received July 31, 2017

Report

Report Number
0001825034-2017-05380
Event Type
Injury
Date Received
July 31, 2017
Date of Event
June 22, 2015
Report Date
July 16, 2018
Manufacturer
BIOMET ORTHOPEDICS
Product Code
JWH
PMA / PMN Number
PK915132
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

UPON RECEIPT OF ADDITIONAL INFORMATION, THIS REPORT WAS DETERMINED TO NOT BE REPORTABLE AS THE PRODUCT DID NOT CAUSE OR CONTRIBUTE TO THE REPORTED EVENT. THE INITIAL REPORT SHOULD BE VOIDED.

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. REPORTED EVENT WAS CONFIRMED BY REVIEW OF MEDICAL RECORDS. DEVICE HISTORY RECORD WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. ROOT CAUSE WAS UNABLE TO BE DETERMINED. 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)(4). CONCOMITANT MEDICAL PRODUCTS: ITEM NAME: REGENEREX 3 PEG SERIES A PATELLA, ITEM NUMBER: 141357, LOT NUMBER: 739320; ITEM NAME: REGENEREX PRIMARY TIBIAL TRAY 71MM, ITEM NUMBER: 141273, LOT NUMBER: 052790; ITEM NAME: VANGUARD E1 TIBIAL BEARING, ITEM NUMBER: EP-183542, LOT NUMBER: 207890; ITEM NAME: VANGUARD CR POROUS FEMORAL RT 62.5, ITEM NUMBER: 183046, LOT NUMBER: 168470. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION AS IT REMAINS IMPLANTED. 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: 0001825034-2017-05380/05381/05382/05374/05377/05375/05376/05378/05379/05373. (B)(6).

Additional Manufacturer Narrative · 1

THE FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. 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 THAT A BI-LATERAL PATIENT WHO UNDERWENT A TOTAL KNEE ARTHROPLASTY IS EXPERIENCING PAIN. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE AT THIS TIME. NO REVISION HAS BEEN REPORTED TO DATE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT IS ALSO EXPERIENCING POPPING, CLICKING AND LOCKING OF BOTH KNEES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
534615 BIOMET FINNED PRI STEM 40MM PROSTHESIS, KNEE JWH BIOMET ORTHOPEDICS 539870

Patients

Seq Age Sex Outcome Treatment
1 47 YR Other