FDA Adverse Event Injury Summary report: N

FINN ROTATING HINGED KNEE AXLE

MDR report key: 6836274 · Received August 31, 2017

Report

Report Number
0001825034-2017-06795
Event Type
Injury
Date Received
August 31, 2017
Report Date
December 12, 2017
Manufacturer
BIOMET ORTHOPEDICS
Product Code
KRO
PMA / PMN Number
PK910877
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

UPON RECEIVING ADDITIONAL INFORMATION ON THE REPORTED EVENT, IT WAS DETERMINED TO BE NOT REPORTABLE AS THE X-RAYS REVEALED FEMORAL LOOSENING AND OSTEOLYTIC LESION OF THE PROXIMAL TIBIAL COMPONENT.

Additional Manufacturer Narrative · 1

(B)(4). MEDICAL PRODUCT: CATALOG #: 153986, FINN ROTATING HINGED KNEE MODULAR TIBIAL BEARING, LOT # 374460. CATALOG #: CP111012, FINN ROTATING HINGED KNEE FEMORAL STEM, LOT # 399340. CATALOG #: 153803, FINN ROTATING HINGED KNEE MODULAR SEGMENTAL FEMORAL RIGHT, LOT # 506660. CATALOG #: CP111134, FINN ROTATING HINGED KNEE TIBIAL BASE, LOT # 137000. CATALOG #: 11-150826, BIOMET ARCOM ALL POLYETHYLENE BUTTON, LOT # 863040. CATALOG #: 153861, FINN ROTATING HINGED KNEE LOCK PIN, LOT # 874840. CATALOG #: 153865, FINN ROTATING HINGED KNEE YOKE STANDARD REINFORCED, LOT # 642660. CATALOG #: 153851, FINN ROTATING HINGED KNEE TIBIAL BUSHING, LOT # 938960. CATALOG #: 153852, FINN ROTATING HINGED KNEE FEMORAL BUSHING, LOT # 587230. THE CUSTOMER HAS NOT INDICATED WHETHER THE PRODUCT WILL BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION OR NOT. ONCE THIS INFORMATION IS OBTAINED A FOLLOW-UP MDR WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2017-06779, 06790, 06791, 06792, 06793, 06794, 06927, 06928 AND 06929.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAD AN INITIAL KNEE ARTHROPLASTY ON AN UNKNOWN DATE AND IS BEING REVISED FOR UNKNOWN REASONS ON AN UNKNOWN DATE. 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
614456 FINN ROTATING HINGED KNEE AXLE PROSTHESIS, KNEE KRO BIOMET ORTHOPEDICS N/A 837890

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R