FDA Adverse Event Injury Summary report: N

UNKNOWN BIOMET ARCOM 3 PEG/POST SIZE 31

MDR report key: 7768067 · Received August 9, 2018

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

Additional Manufacturer Narrative · 1

(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.

Description of Event or Problem · 1

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