TRABECULAR METAL TOTAL ANKLE TALAR COMPONENT
Report
- Report Number
- 0001822565-2018-01785
- Event Type
- Injury
- Date Received
- April 5, 2018
- Date of Event
- December 23, 2016
- Report Date
- March 26, 2018
- Manufacturer
- ZIMMER BIOMET, INC.
- Product Code
- HSN
- PMA / PMN Number
- PNA
- Removal / Correction Number
- N/A
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA
- Reporter Occupation
- PHYSICIAN
Narratives
(B)(4). MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: MFR#0001822565-2018-01784 AND MFR#0001822565-2018-01786 CONCOMITANT MEDICAL PRODUCTS: TRABECULAR METAL TOTAL ANKLE TIBIAL BASE COMPONENT PN00830004400 LN63046939 TRABECULAR METAL TOTAL ANKLE TIBIAL INSERT PN00830005400 LN62861441. FOREIGN REPORT SOURCE- (B)(6). THIS PRODUCT IS MANUFACTURED BY ZIMMER BIOMET WARSAW AND IS CLEARED FOR EXPORT ONLY, NOT FOR DISTRIBUTION IN THE U.S. HOWEVER, THIS REPORT IS BEING SUBMITTED AS ZIMMER BIOMET WARSAW MANUFACTURES A SIMILAR DEVICE THAT IS CLEARED OR DISTRIBUTED IN THE UNITED STATES UNDER 510K NUMBER K120906. REPORTED EVENT WAS CONFIRMED BY REVIEW OF THE PROVIDED X-RAYS AND OP NOTES. PER THE OP REPORT, PATIENT HAD SOME ANTERIOR CARTILAGE DAMAGE, INCREASED PAIN, AND A CYST. DHR WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. REVIEW OF THE COMPLAINT HISTORY DETERMINED THAT NO FURTHER ACTION IS REQUIRED. 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 AN INITIAL RIGHT ANKLE REPLACEMENT. SUBSEQUENTLY, THE PATIENT SUFFERED FROM RECURRING HETEROTOPIC OSSIFICATION ONE YEAR LATER. THE PATIENT UNDERWENT DEBRIDEMENT AND REQUIRES REPEAT RADIOABLATION. IT WAS ALSO REPORTED THE PATIENT SUFFERS FROM PAIN, MODERATE SWELLING/STIFFNESS, TIGHT LAXITY, GAIT ABNORMALITY AND RESTRICTION OF HINDFOOT MOTION. NO PLANS HAVE BEEN MADE FOR REVISION AT THIS TIME. .
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 243275 | TRABECULAR METAL TOTAL ANKLE TALAR COMPONENT | PROSTHESIS, ANKLE | HSN | ZIMMER BIOMET, INC. | N/A | 62990953 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 72 YR | Required Intervention |