FDA Adverse Event Death Summary report: N

BIOMET SERIES A STANDARD PATELLA

MDR report key: 7275284 · Received February 15, 2018

Report

Report Number
0001825034-2018-00885
Event Type
Death
Date Received
February 15, 2018
Date of Event
March 12, 2015
Report Date
August 30, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
PK171054
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). MEDICAL PRODUCTS: VANGUARD CR FEMORAL LEFT INTERLOK CAT#: 183036, LOT#: 493750. MAXIM INTERLOK FIXED I-BEAM TIBIAL PLATE WITH LOCKING BAR CAT#: 141226, LOT#: 174380. VANGUARD DCM CR-LIPPED TIBIAL BEARING CAT#: 183564, LOT#: 217590. 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 - 2018 - 00883, 0001825034 - 2018 - 00884, 0001825034 - 2018 - 00885, 0001825034 - 2018 - 00886. REMAINS IMPLANTED.

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. UPON RECEIPT OF ADDITIONAL INFORMATION IT HAS BEEN DETERMINED THAT THE REPORTED DEVICE DID NOT CAUSE OR CONTRIBUTE TO THE EVENT. 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 DIED EIGHT YEARS AFTER KNEE ARTHROPLASTY. THERE IS NO INDICATION THAT THE CAUSE OF DEATH IS IMPLANT OR PROCEDURE RELATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
116950 BIOMET SERIES A STANDARD PATELLA PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A 936630

Patients

Seq Age Sex Outcome Treatment
1 81 YR Death