FDA Adverse Event Injury Summary report: N

UNKNOWN PERSONA KNEE BEARING

MDR report key: 7315788 · Received March 6, 2018

Report

Report Number
0001822565-2018-01146
Event Type
Injury
Date Received
March 6, 2018
Report Date
June 13, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
PNI
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: UNKNOWN PERSONA KNEE FEMORAL CAT#:UNK, LOT#: UNK, UNKNOWN PERSONA KNEE TIBIAL TRAY CAT#:UNK, LOT#: UNK . CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS PRODUCT LOCATION IS UNKNOWN. 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: 0001822565 - 2018 - 01146, 0001822565 - 2018 - 01147, 0001822565 - 2018 - 01148. PRODUCT LOCATION IS UNKNOWN.

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY UPDATED AND ADDITIONAL INFORMATION. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. 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. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001822565-2018-01147-1, 0001822565-2018-01148-1.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAVE PERSONAL INJURY AFTER KNEE IMPLANT, NO FURTHER INFORMATION IS AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
159503 UNKNOWN PERSONA KNEE BEARING PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A NI

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention