FDA Adverse Event Injury Summary report: N

UNKNOWN BIOMET ARCOM PATELLA

MDR report key: 7770526 · Received August 9, 2018

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

Additional Manufacturer Narrative · 1

(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.

Description of Event or Problem · 1

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