FDA Adverse Event Injury Summary report: N

CUSTOM MADE DEVICE MANDEL RIGHT PM-TMJ & MODEL

MDR report key: 7868203 · Received September 12, 2018

Report

Report Number
0001032347-2018-00615
Event Type
Injury
Date Received
September 12, 2018
Date of Event
August 17, 2018
Report Date
February 21, 2019
Manufacturer
BIOMET MICROFIXATION
Product Code
LZD
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. (B)(4). MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 0001032347-2018-00616-1.

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. (B)(4). MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 0001032347-2018-00616-1.

Additional Manufacturer Narrative · 0

THE IMPLANT WAS IMPLANTED (B)(6) 2018 AND EXPLANTED (B)(6) 2018 THEREFORE THE COMPLAINT IS CONSIDERED CONFIRMED. FUNCTIONAL TESTING AND INSPECTIONS COULD NOT BE PERFORMED DUE TO THE PARTS NOT BEING RETURNED. IT WAS REPORTED THAT THE REASON FOR THE REVISION WAS DUE TO AN EAR CANAL INFECTION THAT SPREAD INTO THE FOSSA COMPONENT CAUSED BY PATIENT'S ANATOMY CHANGED OVER THE YEARS. INFECTION WAS NOT CAUSED BY THE IMPLANT. DEVICE HISTORY RECORD (DHR) WAS REVIEWED FOR THE TMJ IMPLANT AND ASSEMBLY SCREW AND NO DISCREPANCIES WERE FOUND. DHR REVIEW WAS UNABLE TO BE PERFORMED FOR THE SCREWS AS THE PART NUMBER AND LOT NUMBER OF THE DEVICES INVOLVED IN THE EVENT ARE UNKNOWN. THERE ARE NO INDICATIONS OF MANUFACTURING DEFECTS. BASED ON THE INFORMATION AND MATERIALS PROVIDED, THERE WAS NOTHING TO SUGGEST THAT THERE WAS AN ALLEGED MALFUNCTION OR INABILITY OF THE IMPLANTS TO FUNCTION AS INTENDED. INVESTIGATION RESULTS CONCLUDED THAT THE REPORTED EVENT WAS DUE TO PATIENT CONDITION. 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 FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 0001032347-2018-00616-2.

Description of Event or Problem · 0

IT WAS REPORTED THE REVISION WAS DUE TO AN EAR CANAL INFECTION THAT SPREAD INTO THE FOSSA COMPONENT CAUSED BY PATIENT'S ANATOMY CHANGED OVER THE YEARS. INFECTION WAS NOT CAUSED BY THE IMPLANT.

Description of Event or Problem · 0

IT WAS REPORTED THE REVISION WAS DUE TO AN EAR CANAL INFECTION THAT SPREAD INTO THE FOSSA COMPONENT CAUSED BY PATIENT'S ANATOMY CHANGED OVER THE YEARS. INFECTION WAS NOT CAUSED BY THE IMPLANT.

Description of Event or Problem · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 1

(B)(4). IMPLANT DATE: "ROUGHLY ON" (B)(6) 2018. CONCOMITANT MEDICAL PRODUCTS: BIOMET MICROFIXATION 2.5 MM X 8 MM ASSEMBLY SCREW, CATALOG #: CP-1928, LOT #: 799370; BIOMET MICROFIXATION UNKNOWN SCREWS, CATALOG #: NI, LOT #: NI. THERAPY DATE: UNKNOWN. FOREIGN COUNTRY: (B)(6). PMA/510(K) NUMBER: THIS PRODUCT IS NOT CLEARED OR DISTRIBUTED IN THE U.S. HOWEVER, THIS REPORT IS BEING SUBMITTED AS BIOMET MICROFIXATION MANUFACTURES A SIMILAR DEVICE THAT IS CLEARED OR DISTRIBUTED IN THE UNITED STATES UNDER PMA NUMBER P020016. 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. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT; PLEASE SEE ASSOCIATED REPORT: 0001032347-2018-00616.

Description of Event or Problem · 1

IT WAS REPORTED THAT AN EMERGENCY EXPLANTATION OF THE CUSTOM TEMPORAL MANDIBULAR JOINT WILL BE PERFORMED. THE DISTRIBUTOR REPORTED, "THE IMPLANT ITSELF DID NOT FAIL. PATIENT ANATOMY AND BONE QUALITY IS NOT GOOD." ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED. NO ADDITIONAL PATIENT CONSEQUENCES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
712185 CUSTOM MADE DEVICE MANDEL RIGHT PM-TMJ & MODEL PATIENT MATCHED TEMPOROMANDIBULAR JOINT IMPLANT LZD BIOMET MICROFIXATION N/A 814820

Patients

Seq Age Sex Outcome Treatment
1 23 YR Hospitalization| R