FDA Adverse Event Injury Summary report: N

TRABECULAR METAL TOTAL ANKLE TALAR COMPONENT

MDR report key: 7399017 · Received April 5, 2018

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

Additional Manufacturer Narrative · 1

(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.

Description of Event or Problem · 1

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