UNKNOWN BIOMET ARCOM PATELLA
Report
- Report Number
- 0001825034-2018-07470
- Event Type
- Injury
- Date Received
- August 9, 2018
- Report Date
- August 8, 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: VANGUARD CR ILOK FEM CATALOG #: 183026 LOT #: UNKNOWN, VGD CRUC RET TIB BRG CATALOG #: 183441 LOT #: UNKNOWN, BIOMET CC I-BEAM TRAY CATALOG #: 141223 LOT #: 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. 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 FILLED FOR THIS EVENT: 0001825034-2018-07367, 0001825034-2018-07468, 0001825034-2018-07469. PRODUCT LOCATION UNKNOWN.
IT WAS REPORTED THAT THE PATIENT UNDERWENT AN INITIAL LEFT KNEE ARTHROPLASTY. SUBSEQUENTLY, THE PATIENT EXPERIENCED URINARY TRACT INFECTION (UTI) AND DEHYDRATION WHICH REQUIRED FURTHER HOSPITALIZATION ON AN UNKNOWN DATE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 611926 | UNKNOWN BIOMET ARCOM PATELLA | PROSTHESIS, KNEE | JWH | ZIMMER BIOMET, INC. | N/A | NI |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Hospitalization| R |