FDA Adverse Event Injury Summary report: N

VANGUARD 360 SSK POSTERIOR FEMORAL AUGMENT

MDR report key: 7120489 · Received December 15, 2017

Report

Report Number
0001825034-2017-11091
Event Type
Injury
Date Received
December 15, 2017
Date of Event
July 11, 2017
Report Date
February 23, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
PK093293
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). FOREIGN: (B)(6). MEDICAL PRODUCTS: VANGUARD DCM TIBIAL BEARING CAT#: 183862, LOT#: 413770. VANGUARD SSK 360 FEMORAL WITH SCREW CAT#: 185283, LOT#: 2780385. BIOMET 360 TIBIAL TRAY WITH TI LOCKING BAR AND SCREW CAT#: 185201, LOT#: 489420. BIOMET SMOOTH KNEE STEM WITH SCREW CAT#: 145026, LOT#: 974240. BIOMET 360 OFFSET ADAPTOR WITH SCREW CAT#: 185212, LOT#: 869810. VANGUARD 360 SSK DISTAL FEMORAL AUGMENT CAT#: 185403, LOT#: 120300. VANGUARD 360 SSK DISTAL FEMORAL AUGMENT CAT#: 185403, LOT#: 675300. BIOMET SMOOTH KNEE STEM CAT#: 145004, LOT#: UNK. BIOMET 360 OFFSET ADAPTOR WITH SCREW CAT#: 185212, LOT#: 869810 . BIOMET 360 TIBIAL AUGMENT CAT#: 185221, LOT#: 147150. BIOMET 360 TIBIAL AUGMENT WITH BOLTS CAT#: 185221, LOT#: 2577939. UNKNOWN BIOMET KNEE PATELLA CAT#: UNK, LOT#: UNK. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS PRODUCT LOCATION IS UNKNOWN. 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 - 11086, 0001825034 - 2017 - 11087, 0001825034 - 2017 - 11088, 0001825034 - 2017 - 11089, 0001825034 - 2017 - 11090, 0001825034 - 2017 - 11091, 0001825034 - 2017 - 11092 , 0001825034 - 2017 - 11093, 0001825034 - 2017 - 11094, 0001825034 - 2017 - 11095, 0001825034 - 2017 - 11096, 0001825034 - 2017 - 11097, 0001825034 - 2017 - 11098. PRODUCT LOCATION IS UNKNOWN.

Additional Manufacturer Narrative · 1

UPON REASSESSMENT OF THE REPORTED EVENT, IT WAS DETERMINED TO BE NOT REPORTABLE AS THERE IS NO INDICATION THAT PATIENT HAS ANY ZIMMER BIOMET COMPONENTS IMPLANTED INTO THE RIGHT KNEE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT LEFT TOTAL KNEE REPLACEMENT TWO YEARS AFTER INITIAL LEFT KNEE ARTHROPLASTY DUE TO UNKNOWN REASON.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
899364 VANGUARD 360 SSK POSTERIOR FEMORAL AUGMENT PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A 675300

Patients

Seq Age Sex Outcome Treatment
1 66 YR Hospitalization| R SEE H10