FDA Adverse Event Injury Summary report: N

VANGUARD UNKNOWN KNEE PATELLA

MDR report key: 7758996 · Received August 7, 2018

Report

Report Number
0001825034-2018-06480
Event Type
Injury
Date Received
August 7, 2018
Date of Event
November 17, 2006
Report Date
September 27, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
PNI
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: VANGUARD CR FEMORAL COMPONENT CAT#:183206, LOT#: UNK, VANGUARD CR TIBIAL BEARING CAT#: 183620, LOT#: UNK, BIOMET CC I-BEAM TRAY CAT#:141222, LOT#:UNK . 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 - 06475, 0001825034 - 2018 - 06476, 0001825034 - 2018 - 06478, 0001825034 - 2018 - 06480. PRODUCT REMAINS IMPLANTED.

Additional Manufacturer Narrative · 1

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. 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 WAS NOTED TO HAVE A FALL RESULTING IN MCL STRAIN FIFTEEN MONTHS AFTER PRIMARY RIGHT TOTAL KNEE ARTHROPLASTY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
598948 VANGUARD UNKNOWN KNEE PATELLA PROSTHESIS KNEE JWH ZIMMER BIOMET, INC. N/A NI

Patients

Seq Age Sex Outcome Treatment
1 40 YR Other