UNKNOWN BIOMET ARCOM 3 PEG/POST SIZE 31
Report
- Report Number
- 0001825034-2018-07406
- Event Type
- Injury
- Date Received
- August 9, 2018
- Date of Event
- June 9, 2009
- Report Date
- August 9, 2018
- Manufacturer
- ZIMMER BIOMET, INC.
- Product Code
- JWH
- PMA / PMN Number
- PN/A
- 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: 183443 VGD CRUC RET TIB BRG 13X71/75 UNKNOWN, 141223 BIOMET CC I-BEAM TRAY 71MM UNKNOWN, UNKNOWN BIOMET ARCOM 3 PEG/POST SIZE 31 UNKNOWN. 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. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034 - 2018 - 07386, 0001825034 - 2018 - 07392, 0001825034 - 2018 - 07395. 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.
IT WAS REPORTED A PATIENT UNDERWENT PRIMARY RIGHT TOTAL KNEE ARTHROPLASTY AND UNDERWENT I&D DUE TO NON-HEALING SURGICAL WOUND ONE YEAR POST IMPLANTATION. NO ADDITIONAL INFORMATION IS AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 608387 | UNKNOWN BIOMET ARCOM 3 PEG/POST SIZE 31 | PROSTHESIS, KNEE | JWH | ZIMMER BIOMET, INC. | N/A | NI |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 63 YR | Hospitalization| R |