FDA Adverse Event Injury Summary report: N

LPS FLEX FEMORAL COMPONENT

MDR report key: 7784685 · Received August 15, 2018

Report

Report Number
0001822565-2018-04303
Event Type
Injury
Date Received
August 15, 2018
Date of Event
July 12, 2018
Report Date
October 10, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
PK062768
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DEVICE WAS NOT RETURNED. DHR WAS REVIEWED FOR DEVIATIONS AND / OR ANOMALIES WITH NO DEVIATIONS / ANOMALIES IDENTIFIED A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. 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.

Additional Manufacturer Narrative · 1

(B)(4). MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 0001822565-2018-04305, 0001822565-2018-04306. (B)(4). CONCOMITANT MEDICAL PRODUCTS. ARTICULAR SURFACE USE WITH LPS/LPS-FLEX 51 OR 52 SUFFIX FEMORALS SIZE EF 10 MM HEIGHT. ITEM# 00596204010 LOT# 63615052. TIBIAL COMPONENT STEMMED PRECOAT USE OF THIS TIBIAL COMPONENT WITH LEGACY KNEE - CONSTRAINED CONDYLAR KNEE (LCCK) ARTICULATING SURFACES REQUIRES USING ITEM# 00-5980-047-01 LOT# 63392593. (B)(6). CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT AND INITIAL ARTHROPLASTY. SUBSEQUENTLY, THE PATIENT WAS REVISED DUE TO INFECTION. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
627938 LPS FLEX FEMORAL COMPONENT PROSTHESIS- KNEE JWH ZIMMER BIOMET, INC. N/A 63597351

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R