FDA Adverse Event Injury Summary report: N

BIOMET ARCOM PATELLA

MDR report key: 7151746 · Received December 28, 2017

Report

Report Number
0001825034-2017-11429
Event Type
Injury
Date Received
December 28, 2017
Report Date
March 2, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
PK921182
Removal / Correction Number
Z-1858/1863-2017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). ADDITIONAL CONCOMITANT MEDICAL PRODUCTS: VANGUARD INTERLOK FEMORAL, CATALOG #: 183202 LOT #: 149220; BIOMET CRUCIATE TRAY, CATALOG #: 141233 LOT #: J3811794. 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: 0001825034-2017-11423, 0001825034-2017-11427, 0001825034-2017-11428, 0001825034-2017-11429. REMAINS IMPLANTED.

Additional Manufacturer Narrative · 1

REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. 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. DEVICE WAS IDENTIFIED TO BE IN SCOPE OF PREVIOUSLY INITIATED RECALL, HOWEVER IT CANNOT BE DETERMINED IF THE REPORTED ISSUE WAS RELATED TO THE RECALL. 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 WAS REPORTED THAT THE PATIENT IS SUFFERING FROM PAIN AND SWELLING IN THE KNEE. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
932301 BIOMET ARCOM PATELLA PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A 230530

Patients

Seq Age Sex Outcome Treatment
1 Other| R