VNGD CR TIB BRG 14X71/75
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
(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.
(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.
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 |