FDA Adverse Event Injury Summary report: N

VANGUARD POSTERIOR STABILIZED FEMORAL

MDR report key: 6927771 · Received October 7, 2017

Report

Report Number
0001825034-2017-08012
Event Type
Injury
Date Received
October 7, 2017
Report Date
March 1, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
PK113550
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
PHYSICIAN

Narratives

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.

Additional Manufacturer Narrative · 1

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

REPORTED EVENT WAS UNABLE TO BE CONFIRMED. DHR WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT 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). MEDICAL PRODUCT: BIOMET CRUCIATE TRAY, CAT#: 141234 LOT#: J3790936. VANGUARD POSTERIOR STABILIZED TIBIAL BEARING, CAT#: EP-183642 LOT#: 113380. SERIES-A STANDARD PATELLA, CAT#: 184764 LOT#: 179220. PALACOS BONE CEMENT, CAT#: 00111314001 LOT#: 83314477. PALACOS BONE CEMENT, CAT#: 00111214001 LOT#: 83724480. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS THE PRODUCT REMAINS IMPLANTED. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. 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: 0001825034-2017-08012, 0001825034-2017-08013, 0001825034-2017-08014, 0001825034-2017-08015. REMAINS IMPLANTED.

Description of Event or Problem · 1

IT IS NOW REPORTED THAT THE PATIENT IS EXPERIENCING STIFFNESS, SWELLING AND DIFFICULTY WALKING.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT IS EXPERIENCING EXTREME PAIN IN THE KNEE. THE PATIENT HAS HAD TWO PROCEDURES TO REPAIR THE MENISCUS. NO ADDITIONAL PATIENT CONSEQUENCES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
706852 VANGUARD POSTERIOR STABILIZED FEMORAL PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A J3735940

Patients

Seq Age Sex Outcome Treatment
1 57 YR Other