FDA Adverse Event Injury Summary report: N

TESS CEMENTED ANATOMIC GLENOID IMPLANT

MDR report key: 7340695 · Received March 15, 2018

Report

Report Number
3006946279-2018-00095
Event Type
Injury
Date Received
March 15, 2018
Report Date
March 15, 2018
Manufacturer
BIOMET FRANCE S.A.R.L.
Product Code
KWS
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). AS BIOMET (B)(4) DID NOT RECEIVE ANY INFORMATION ABOUT THE INVOLVED BATCH NUMBER AND AS THE PRODUCT HAS NOT BEEN RETURNED, BIOMET FRANCE WAS NOT ABLE TO PERFORM ANY BATCH AND MANUFACTURING DOCUMENTATION REVIEW AND PRODUCT ANALYSIS COULD NOT BE PERFORMED. HOWEVER THIS EVENT IS CATEGORIZED AS A COMPLAINT AND COULD BE REOPENED IF FURTHER INFORMATION/PRODUCT IS RECEIVED LATER.

Description of Event or Problem · 1

IT HAS BEEN REPORTED THAT THE PATIENT HAS A WELL FIXED TESS HUMERAL ANATOMIC COMPONENT. THE SURGEON REQUESTED A GLENOID REPLACEMENT, AFTER A FAILED CEMENTED ANATOMIC GLENOID IMPLANT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
186406 TESS CEMENTED ANATOMIC GLENOID IMPLANT PROTHESIS, SHOULDER KWS BIOMET FRANCE S.A.R.L.

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention