FDA Adverse Event
Injury
Summary report: N
BIOMET MODULAR TIBIAL SYSTEM
MDR report key: 7540589
·
Received May 24, 2018
Report
- Report Number
- 0009610576-2018-00021
- Event Type
- Injury
- Date Received
- May 24, 2018
- Report Date
- May 24, 2018
- Manufacturer
- BIOMET SPAIN, S.L.
- Product Code
- KRO
- PMA / PMN Number
- PSEE H10
- Removal / Correction Number
- N/A
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SP
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
(B)(4). FOREIGN: (B)(6). THIS DEVICE IS NOT MANUFACTURED BY ZIMMER BIOMET IN THE UNITED STATES; HOWEVER, WE ARE FILING THIS REPORT AS ZIMMER BIOMET MANUFACTURES A SIMILAR DEVICE IN THE UNITED STATES UNDER 510K NUMBER K945028.
Description of Event or Problem · 1
DURING THE PERFORMANCE OF THE SCHEDULE PMS 17 BTMS SISTEMA MODULAR TIBIAL BIOMET REV.4, THE SURVEY PERFORMED BY DR. (B)(6), (B)(6) REVEALS SOME ISSUES RELATED TO BIOMET MODULAR TIBIAL SYSTEM: DEEP INFECTION >3 MONTHS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 384219 | BIOMET MODULAR TIBIAL SYSTEM | PROSTHESIS, KNEE | KRO | BIOMET SPAIN, S.L. | N/A | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |