BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN AGC KNEE

    MDR report key: 6942899 · Received October 11, 2017

    Report

    Report Number
    0001825034-2017-08173
    Event Type
    Injury
    Date Received
    October 11, 2017
    Report Date
    October 6, 2017
    Manufacturer
    ZIMMER BIOMET, INC.
    Product Code
    JWH
    PMA / PMN Number
    PUNKNOWN
    Removal / Correction Number
    N/A
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    ZIMMER BIOMET COMPLAINT: (B)(4). REPORTED EVENT WAS UNABLE TO BE CONFIRMED AS PART NUMBER AND LOT NUMBER OF THE DEVICE INVOLVED IN THE INCIDENT IS UNKNOWN. DEVICE HISTORY RECORD REVIEW WAS UNABLE TO BE PERFORMED AS THE LOT NUMBER OF THE DEVICE INVOLVED IN THE EVENT IS UNKNOWN. 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. YANG, J., YOON, J., OH, C., & KIM, T. (2012). HYBRID COMPONENT FIXATION IN TOTAL KNEE ARTHROPLASTY. THE JOURNAL OF ARTHROPLASTY, 27(6), 1111-1118. DOI:10.1016/J.ARTH.2011.09.019 - (B)(4).

    Description of Event or Problem · 1

    IT WAS REPORTED THAT TWO (2) REVISIONS OF AGC KNEES DUE TO FEMORAL COMPONENTS SHOWED CLEAR SIGNS OF LOOSENING WITH OSTEOLYSIS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    719496 UNKNOWN AGC KNEE KNEE PROSTHESIS JWH ZIMMER BIOMET, INC. N/A UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R