FDA Adverse Event Injury Summary report: N

BIOMET CC I-BEAM TRAY 67MM

MDR report key: 7767278 · Received August 9, 2018

Report

Report Number
0001825034-2018-07337
Event Type
Injury
Date Received
August 9, 2018
Date of Event
March 17, 2008
Report Date
August 8, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
HRY
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 · 1

(B)(4). ADDITIONAL CONCOMITANT MEDICAL PRODUCTS: VANGUARD CR ILOK FEM-RT 60 CATALOG# 183004 LOT# UNK; VNGD CR LIP TIB BRG 12X63/67 CATALOG# 183522 LOT# UNK; UNKNOWN PATELLA. 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 MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS 0001825034 - 2018 - 07338, 0001825034 - 2018 - 07336, 0001825034 - 2018 - 07334.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT A KNEE ARTHROPLASTY. SUBSEQUENTLY, IT WAS NOTED PATIENT HAD A URINARY TRACT INFECTION APPROXIMATELY ONE MONTH POST IMPLANTATION. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
607886 BIOMET CC I-BEAM TRAY 67MM PROSTHESIS, KNEE HRY ZIMMER BIOMET, INC. N/A NI

Patients

Seq Age Sex Outcome Treatment
1 71 YR Hospitalization| R