FDA Adverse Event Injury Summary report: N

VANGUARD XP TIBIAL BEARING-LEFT LATERAL

MDR report key: 7288784 · Received February 22, 2018

Report

Report Number
0001825034-2018-01258
Event Type
Injury
Date Received
February 22, 2018
Date of Event
June 26, 2014
Report Date
February 21, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
OIY
PMA / PMN Number
PK122160
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: VANGUARD XP FEMORAL INTERLOK WITH PEGS, CATALOG#: 195214, LOT#: 990240. VANGUARD XP TIBIAL TRAY-INTERLOK, CATALOG#: 195248, LOT#: 752560. VANGUARD XP TIBIAL BEARING-LEFT MEDIAL, CATALOG#: 195437, LOT#: 825590. THE DEVICE WAS NOT RETURNED FOR EVALUATION DUE TO UNKNOWN LOCATION. REVIEW OF THE DEVICE HISTORY RECORD (DHR) FOUND NO DEVIATIONS OR ANOMALIES. REVIEW OF COMPLAINT HISTORY FOR SAME OR SIMILAR ISSUE IDENTIFIED SIX ADDITIONAL COMPLAINTS FOR PART (ITEM) NUMBER AND FOUR ADDITIONAL COMPLAINTS WERE IDENTIFIED FOR PART/LOT COMBINATION. WITHOUT THE OPPORTUNITY TO EVALUATE THE DEVICE, THE COMPLAINT WAS NOT CONFIRMED AND ROOT CAUSE COULD NOT BE DETERMINED. THERE ARE WARNINGS IN THE PACKAGE INSERT THAT THIS TYPE OF EVENT CAN OCCUR AND RISKS ARE ADDRESSED IN RISK DOCUMENTATION. ASSOCIATED RISK TABLE LISTS "MISCELLANEOUS USER NEEDS (GENERAL POST-OPERATIVE PAIN )¿. FOLLOWING REVIEW, NO NEW RISKS WERE IDENTIFIED. 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: 0001825034-2018-01255/01256/01259. THIS REPORT IS BEING SUBMITTED LATE AS IT HAS BEEN IDENTIFIED IN REMEDIATION.

Description of Event or Problem · 1

IT WAS REPORTED AS PART OF A CLINICAL STUDY THAT A PATIENT UNDERWENT A LEFT KNEE PROCEDURE ON (B)(6) 2014. SUBSEQUENTLY, THE PATIENT REPORTED MODERATE PAIN, PROBLEMS WITH WALKING AND PERFORMING DAILY ACTIVITIES, OFTEN LIMPING, AND DIFFICULTY USING STAIRS DURING THE SIX (6) MONTH, ONE (1) AND TWO (2) YEAR FOLLOW UP VISITS. IT WAS ALSO REPORTED THAT THE PATIENT WAS STILL USING A CANE 2 YEARS POST IMPLANT. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
134222 VANGUARD XP TIBIAL BEARING-LEFT LATERAL PROSTHESIS, KNEE OIY ZIMMER BIOMET, INC. N/A 677800

Patients

Seq Age Sex Outcome Treatment
1 70 YR Other| R