FDA Adverse Event Injury Summary report: N

VNGD CR TIB BRG 14X71/75

MDR report key: 7759080 · Received August 7, 2018

Report

Report Number
0001825034-2018-06555
Event Type
Injury
Date Received
August 7, 2018
Date of Event
February 13, 2008
Report Date
October 1, 2018
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
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

(B)(4). REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DEVICE HISTORY RECORD (DHR) WAS REVIEWED AND NO DISCREPANCIES FOUND. NO DEVICE FAILURE REPORTED. REPORTED ISSUE IS PROCEDURE RELATED. 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.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: VANGUARD FEMORAL COMPONENT, CATALOG# 183010, LOT# UNKNOWN; VANGUARD BEARING, CATALOG# 183444, LOT# UNKNOWN; BIOMET TIBIAL TRAY, CATALOG# 141224, LOT# UNKNOWN; BIOMET PATELLA, CATALOG# UNKNOWN, LOT# UNKNOWN. 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: 0001825034-2018-06554, 0001825034-2018-06556, 0001825034-2018-06557.

Description of Event or Problem · 1

IT WAS REPORTED A PATIENT UNDERWENT PRIMARY RIGHT TOTAL KNEE ARTHROPLASTY. PATIENT WAS NOTED TO HAVE HOSPITALIZATION DUE TO PNEUMONIA AND BOWEL OBSTRUCTION EIGHT DAYS POST-OP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
597979 VNGD CR TIB BRG 14X71/75 PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A NI

Patients

Seq Age Sex Outcome Treatment
1 73 YR Hospitalization| R