FDA Adverse Event Injury Summary report: N

VGXP XP E1 TIB BRG RM 9X71

MDR report key: 7279537 · Received February 18, 2018

Report

Report Number
0001825034-2017-10889
Event Type
Injury
Date Received
February 18, 2018
Date of Event
January 16, 2015
Report Date
December 5, 2017
Manufacturer
ZIMMER BIOMET, INC.
Product Code
MBH
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ZIMMER BIOMET COMPLAINT - (B)(4). CONCOMITANT PRODUCTS: CAT#195248; LOT#984380 - VNGD XP INLK PRI TIB TRAY 69MM, CAT#195332; LOT#986490 - VGXP XP E1 TIB BRG RL 9X71, CAT#195203; LOT#088070 - VGXP INTLK FMRL RT 60. RELATED MFR REPORTS: 0001825034-2017-10878, 0001825034-2017-10886, 0001825034-2017-10890. PRODUCT WAS NOT RETURNED AND NO PHOTOS OF THE DEVICE WERE PROVIDED; THEREFORE, NO EVALUATIONS COULD BE CONDUCTED. REVIEW OF DEVICE HISTORY RECORDS FOR PN 195402 LN 986570 FOUND THESE UNITS WERE RELEASED TO DISTRIBUTION WITH NO DEVIATIONS OR ANOMALIES. THE REPORTED DEVICES ARE USED FOR TREATMENT. THESE COMPONENTS WERE REVIEWED FOR COMPATIBILITY WITH NO ISSUES NOTED. REVIEW OF THE OPERATIVE RECORD INDICATES THAT THE SURGEON NOTED NO COMPLICATIONS. SURGICAL NOTES WERE NOT PROVIDED; IT IS UNKNOWN WHETHER THE COMPONENTS WERE IMPLANTED WITH THE CORRECT FIT AND ORIENTATION AS PER THE SURGICAL TECHNIQUE. WITHOUT THE OPPORTUNITY TO EXAMINE THE COMPLAINT PRODUCT, ROOT CAUSE CANNOT BE DETERMINED. NO CORRECTIVE ACTIONS, PREVENTIVE ACTIONS, OR FIELD ACTIONS RESULTED AFTER INVESTIGATION OF THIS 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. THIS REPORT IS BEING SUBMITTED LATE AS IT HAS BEEN IDENTIFIED IN REMEDIATION.

Additional Manufacturer Narrative · 1

ADDED: EVENT DATE. THIS COMPLAINT REMAINS CLOSED, AS THE ADDITIONAL INFORMATION DOES NOT AFFECT THE OUTCOME OF THE INVESTIGATION.

Description of Event or Problem · 1

CLINICAL STUDY (B)(6)- THE PATIENT UNDERWENT RIGHT KNEE SURGERY ON (B)(6) 2014. IT WAS REPORTED THAT THE PATIENT WAS USING CRUTCHES OR A WALKER AT 7 WEEKS POST-OP. DURING THE 3 MONTH FOLLOW UP VISIT THAT THE PATIENT REPORTED PROBLEMS WALKING, PROBLEMS PERFORMING USUAL ACTIVITIES, EXTREME PAIN, IMPOSSIBLE TO WALK DOWN STAIRS. SATISFACTION RATING WAS "VERY UNSATISFIED/I HAVE NEVER BEEN HAPPY."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
122794 VGXP XP E1 TIB BRG RM 9X71 PROSTHESIS - KNEE MBH ZIMMER BIOMET, INC. N/A 986570

Patients

Seq Age Sex Outcome Treatment
1 62 YR Other