FDA Adverse Event Injury Summary report: N

VANGUARD TIBIAL BEARING

MDR report key: 6787124 · Received August 10, 2017

Report

Report Number
0001825034-2017-06185
Event Type
Injury
Date Received
August 10, 2017
Date of Event
June 16, 2014
Report Date
September 10, 2018
Manufacturer
BIOMET ORTHOPEDICS
Product Code
MBH
PMA / PMN Number
PK171054
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. REPORT WAS PREVIOUSLY MARKED AS A PRODUCT PROBLEM IN ERROR. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INVESTIGATIVE INPUTS PROVIDED BY THE CUSTOMER. DHR WAS REVIEWED AND NO RELATED MANUFACTURING DEVIATIONS OR ANOMALIES WERE IDENTIFIED. ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. 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). MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2017-06183, 0001825034-2017-06184, 0001825034-2017-06186, 0001825034-2017-06187. CONCOMITANT MEDICAL PRODUCTS ¿ RGX 3 PEG SER A PATELLA 34MM CATALOG # 141357, LOT # 305950, BMET REGENX PRI TIB TRAY 79MM CATALOG # 141275, LOT # 106510, BIOMET FINNED PRI STEM 40MM CATALOG # 141314, LOT # 255870, VANGUARD CR POR FMRL-LT 70 CATALOG # 183072 LOT # 614310, STAGRAFT DBM PUTTY 5CC CATALOG # 92-2003, LOT # 668040. THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS; HOWEVER, AN INVESTIGATION OF THE REPORTED EVENT IS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED,A SUPPLEMENTAL MEDWATCH 3500A WILL BE SUBMITTED.

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING FILLED TO RELAY ADDITIONAL INFORMATION, WHICH WAS UNKNOWN A THE TIME OF THE INITIAL MEDWATCH.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT LEFT TOTAL KNEE ARTHROPLASTY AND HAS EXPERIENCED PAIN, IMMEDIATE POST OPERATIVE PRESSURE, LOOSENING, BURNING SENSATION AND SWELLING. A DETERMINATION BY PHYSICIAN AS TO WHETHER THE PATIENT WILL NEED REVISION IS TO FOLLOW. THERE IS NO ADDITIONAL INFORMATION AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
566275 VANGUARD TIBIAL BEARING PROSTHESIS, KNEE MBH BIOMET ORTHOPEDICS N/A 598560

Patients

Seq Age Sex Outcome Treatment
1 57 YR Required Intervention