FDA Adverse Event Injury Summary report: N

VANGUARD POSTERIOR STABILIZED TIBIAL BEARING

MDR report key: 7470346 · Received April 27, 2018

Report

Report Number
0001825034-2018-03073
Event Type
Injury
Date Received
April 27, 2018
Report Date
January 8, 2019
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
PK171054
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THE PRODUCT WAS EVALUATED THROUGH MANUFACTURING REVIEW, HOWEVER, THE REPORTED EVENT COULD NOT BE CONFIRMED. THE DEVICE HISTORY RECORDS WERE REVIEWED AND NO DISCREPANCIES WERE IDENTIFIED. A DEFINITIVE ROOT CAUSE COULD NOT BE DETERMINED WITH THE INFORMATION 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 · 0

NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: VANGUARD INTERLOK FEMORAL COMPONENT, CATALOG #: 183210, LOT #: 250570, BIOMET CRUCIATE TIBIAL TRAY, CATALOG #: 141234, LOT #: J3925075, SERIES-A ASYMMETRIC PATELLA, CATALOG #: 184793, LOT #: 455510. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS THE PRODUCT REMAINS IMPLANTED. 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: 0001825034-2018-03073, 0001825034-2018-03074, 0001825034-2018-03075, 0001825034-2018-03076. REMAINS IMPLANTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT IS EXPERIENCING PAIN, DISCOMFORT AND NERVE DAMAGE CAUSING NUMBNESS. ALL OF THESE ISSUES HAVE BEEN ONGOING SINCE INITIAL IMPLANTATION. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
310786 VANGUARD POSTERIOR STABILIZED TIBIAL BEARING PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A 326510

Patients

Seq Age Sex Outcome Treatment
1 Other