NEXGEN DISTAL FEMORAL AUGMENTS
Report
- Report Number
- 0001822565-2018-01481
- Event Type
- Injury
- Date Received
- March 13, 2018
- Date of Event
- February 21, 2017
- Report Date
- April 5, 2018
- Manufacturer
- ZIMMER BIOMET, INC.
- Product Code
- JWH
- PMA / PMN Number
- PK946150
- Removal / Correction Number
- N/A
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AS
- Reporter Occupation
- PHYSICIAN
Narratives
(B)(4). ADDITIONAL CONCOMITANT MEDICAL PRODUCTS: NEXGEN LCCK ARTICULAR SURFACE CATALOG # 00599403210 LOT # 62841440; NEXGEN LCCK FEMORAL COMPONENT CATALOG # 00599401692 LOT # 62941772; NEXGEN ALL POLY PATELLA CATALOG # 00597206529 LOT # 62913325; NEXGEN TIBIAL COMPONENT CATALOG # 00598003701 LOT # 63064339; NEXGEN PRE FEM AUGMENTS CATALOG # 00-5990-036-01 LOT # 62998830; NEXGEN AUGMENTS DISTAL ONLY FEMORAL CATALOG # 00599003621 LOT # 62591559; NEXGEN STEM EXTENSION CATALOG # 00598801012 LOT # 62937550; NEXGEN STEMS EXTENSION CATALOG # 00598801010 LOT # 62860982; NEXGEN TIBIAL BLOCK AND SCREWS CATALOG # 00598800327 LOT # 62925302; NEXGEN TIBIAL BLOCK AND SCREWS CATALOG # 00598800327 LOT # 62641746. (B)(6). CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED BECAUSE PRODUCT LOCATION IS UNKNOWN. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILLED FOR THIS EVENT: 0001822565-2018-01323, 0001822565-2018-01465, 0002648920-2018-00186, 0002648920-2018-00187, 0002648920-2018-00188, 0001822565-2018-01476, 0002648920-2018-00189, 0002648920-2018-00190, 0001822565-2018-01483, 0001822565-2018-01484.
THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: 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. 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
IT WAS REPORTED THAT THE PATIENT UNDERWENT A FIRST REVISION KNEE ARTHROPLASTY DUE TO AN UNKNOWN REASON.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 176478 | NEXGEN DISTAL FEMORAL AUGMENTS | PROSTHESIS KNEE | JWH | ZIMMER BIOMET, INC. | N/A | 62998879 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Hospitalization| R |