FDA Adverse Event Injury Summary report: N

VANGUARD CR ILOK FEM-LT 65

MDR report key: 7756282 · Received August 7, 2018

Report

Report Number
0001825034-2018-05459
Event Type
Injury
Date Received
August 7, 2018
Date of Event
February 22, 2016
Report Date
August 1, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
PK113550
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: VGD CRUC RET TIB BRG 11X71/75 CATALOG# 183441, LOT# UNK, BIOMET CC I-BEAM TRAY 71MM, CATALOG# 141223, LOT# UNK, SERIES (B)(6), CATALOG# 184764, LOT# UNK. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DEVICE HISTORY RECORD (DHR) REVIEW WAS UNABLE TO BE PERFORMED AS THE LOT NUMBER OF THE DEVICE INVOLVED IN THE EVENT IS UNKNOWN. 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 MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2018-05460.

Description of Event or Problem · 1

IT WAS REPORTED PATIENT UNDERWENT A KNEE ARTHROPLASTY, AND SUBSEQUENTLY HAD A MANIPULATION PROCEDURE UNDER ANESTHESIA APPROXIMATELY ONE MONTH POST IMPLANTATION. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
600574 VANGUARD CR ILOK FEM-LT 65 PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A NI

Patients

Seq Age Sex Outcome Treatment
1 65 YR Hospitalization| R