FDA Adverse Event Injury Summary report: N

VNGD CR TIB BRG 14X79/83

MDR report key: 7768009 · Received August 9, 2018

Report

Report Number
0001825034-2018-07719
Event Type
Injury
Date Received
August 9, 2018
Date of Event
January 17, 2006
Report Date
August 9, 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). MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 0001825034-2018-07717, 0001825034-2018-07720, 0001825034-2018-07721. CONCOMITANT MEDICAL PRODUCTS: VANGUARD CR ILOK FEM-RT 75, ITEM# 183014, LOT# UNKNOWN. BIOMET CC I-BEAM TRAY 79MM, ITEM# 141225, LOT# UNKNOWN. UNKNOWN PATELLA, ITEM# UNKNOWN, LOT# UNKNOWN. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED BECAUSE IT REMAINS IMPLANTED. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DEVICE WAS NOT RETURNED. 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.

Description of Event or Problem · 1

IT WAS REPORTED A PATIENT UNDERWENT PRIMARY RIGHT TOTAL KNEE ARTHROPLASTY AND SUBSEQUENTLY THE PATIENT WAS NOTED TO HAVE UTI TREATED WITH LEVAQUIN. PATIENT EXPERIENCED A FALL AND BLISTERS NOTED ON A LATER DATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
610243 VNGD CR TIB BRG 14X79/83 PROSTHESIS- KNEE HRY ZIMMER BIOMET, INC. N/A UNK

Patients

Seq Age Sex Outcome Treatment
1 76 YR Required Intervention