FDA Adverse Event Injury Summary report: N

OXF ANAT BRG RT LG SIZE 5 PMA

MDR report key: 7120383 · Received December 15, 2017

Report

Report Number
3002806535-2017-01207
Event Type
Injury
Date Received
December 15, 2017
Date of Event
July 11, 2017
Report Date
May 8, 2018
Manufacturer
BIOMET UK LTD.
Product Code
NRA
PMA / PMN Number
PP010014
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: OXF UNI CMNTLS TIB SZ F RM, ITEM NO: 166581, LOT NO: 3840645, OXFORD PH3 CEMENTLESS FEM SZ L, ITEM NO: 154927, LOT NO: 3890293. REPORT SOURCE, FOREIGN - EVENT OCCURRED IN (B)(6). THE INVESTIGATION IS IN PROCESS. 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: 3002806535-2017-01205, 3002806535-2017-01207.

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DEVICE HISTORY RECORD (DHR) WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. 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.

Description of Event or Problem · 1

IT HAS BEEN REPORTED BY THE HOSPITAL THAT A PATIENT UNDERWENT AN INITIAL RIGHT KNEE REPLACEMENT SURGERY. SUBSEQUENTLY, A REVISION PROCEDURE WAS PERFORMED DUE TO INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
902488 OXF ANAT BRG RT LG SIZE 5 PMA KNEE PROSTHESIS NRA BIOMET UK LTD. N/A 3841191

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R