FDA Adverse Event Injury Summary report: N

VANGUARD CRUCIATE RETAINING INTERLOK FEMORAL COMPONENT LEFT 62.5

MDR report key: 7762841 · Received August 8, 2018

Report

Report Number
0001825034-2018-06874
Event Type
Injury
Date Received
August 8, 2018
Report Date
September 18, 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 · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. 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.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT DEVICES ¿ VANGUARD CRUCIATE RETAINING TIBIAL BEARING 16X63/67 CATALOG #: 183426 LOT #: NI, BIOMET CC I-BEAM TIBIAL TRAY 67MM CATALOG #: 141222 LOT #: NI, UNKNOWN BIOMET ARCOM 3-PEG PATELLA CATALOG #: NI LOT #: NI. IT IS INDICATED BY THE COMPLAINANT THAT THE DEVICES WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS THE DEVICES REMAIN IMPLANTED. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2018-06875, 0001825034-2018-06876, 0001825034-2018-06877. DEVICE REMAINS IMPLANTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT DEVELOPED MILD CELLULITIS FOLLOWING LEFT KNEE ARTHROPLASTY. IT IS UNKNOWN HOW LONG THE KNEE PROSTHESES WERE IMPLANTED PRIOR TO THE DEVELOPMENT OF INFECTION. NO ADDITIONAL PATIENT CONSEQUENCES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
602084 VANGUARD CRUCIATE RETAINING INTERLOK FEMORAL COMPONENT LEFT 62.5 PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A NI

Patients

Seq Age Sex Outcome Treatment
1 Other