VNGD CR TIB BRG 14X63/67
Report
- Report Number
- 0001825034-2018-07250
- Event Type
- Injury
- Date Received
- August 8, 2018
- Date of Event
- April 18, 2005
- Report Date
- September 7, 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
(B)(4). CONCOMITANT MEDICAL PRODUCTS - VANGUARD FEMORAL COMPONENT CATALOGUE# 183006 LOT# UNKNOWN, VANGUARD BEARING CATALOGUE# 183424 LOT# UNKNOWN, BIOMET TIBIAL TRAY CATALOGUE# 141222 LOT# UNKNOWN, BIOMET PATELLA CATALOGUE# 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: 0001825034-2018-070248, 0001825034-2018-070250.
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 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. REMAINS IMPLANTED.
IT WAS REPORTED A PATIENT UNDERWENT RIGHT PRIMARY TOTAL KNEE ARTHROPLASTY. PATIENT UNDERWENT MANIPULATION THE NEXT MONTH.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 605017 | VNGD CR TIB BRG 14X63/67 | PROSTHESIS, KNEE | JWH | ZIMMER BIOMET, INC. | N/A | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 71 YR | Required Intervention |