FDA Adverse Event Injury Summary report: N

VNGD CR TIB BRG 14X63/67

MDR report key: 7764702 · Received August 8, 2018

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

Additional Manufacturer Narrative · 1

(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.

Additional Manufacturer Narrative · 1

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.

Description of Event or Problem · 1

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