FDA Adverse Event Injury Summary report: N

VANGUARD SERIES-STANDARD PATELLA

MDR report key: 7150676 · Received December 28, 2017

Report

Report Number
0001825034-2017-11442
Event Type
Injury
Date Received
December 28, 2017
Date of Event
December 2, 2017
Report Date
January 17, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
HRY
PMA / PMN Number
PK040770
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. NO DEVICES OR PHOTOS WERE RECEIVED; THEREFORE THE CONDITION OF THE COMPONENTS IS UNKNOWN. DHR WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. REVIEW OF THE COMPLAINT HISTORY DETERMINED THAT NO FURTHER ACTION IS REQUIRED AS NO TRENDS WERE IDENTIFIED. ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE INFORMATION PROVIDED WAS LIMITED. 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

CMP-(B)(4). CONCOMITANT MEDICAL PRODUCTS: VANGUARD PS TIBIAL BEARING, CAT#: 183620, LOT#: 579430. BIOMET PRIMARY TIBIAL MODULAR TRAY, CAT #: 951660, LOT#: 697270. BIOMET MODULAR FINNED STEM, CAT #: 141314, LOT#: 806740. 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: 0001825034-2017-11441, 0001825034-2017-11443, 0001825034-2017-11444.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT¿S POST-OPERATIVE OUTCOME IS ABNORMAL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
930369 VANGUARD SERIES-STANDARD PATELLA PROSTHESIS, KNEE HRY ZIMMER BIOMET, INC. N/A 697270

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention