FDA Adverse Event Injury Summary report: N

COMPRESS ANTI-ROTATION SPINDLE

MDR report key: 7934107 · Received October 4, 2018

Report

Report Number
0001825034-2018-09422
Event Type
Injury
Date Received
October 4, 2018
Report Date
July 16, 2019
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWA
PMA / PMN Number
PK101475
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

UPON RECEIPT OF ADDITIONAL INFORMATION, IT WAS DETERMINED THAT THE INITIAL REPORT WAS SUBMITTED IN ERROR AND SHOULD BE VOIDED.

Description of Event or Problem · 0

UPON RECEIPT OF ADDITIONAL INFORMATION, IT WAS DETERMINED THAT THE INITIAL REPORT WAS SUBMITTED IN ERROR AND SHOULD BE VOIDED.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCT: OSS SEGMENTAL FEMORAL COMPONENT CATALOG # 150355 LOT # 267280; OSS TIBIAL BEARING CATALOG # 150411 LOT # 312720; OSS FEMORAL BUSHINGS SET CATALOG # 150477 LOT # 040920; OSS FEMORAL BUSHINGS SET CATALOG # 150477 LOT # 918980; OSS YOKE CATALOG # 150493 LOT # 991160; OSS TIBIAL BUSHING CATALOG # 150476 LOT # 581390; OSS NON-MODULAR LONG TIBIAL BASEPLATE CATALOG # 161043 LOT # 068050; COMPRESS DEVICE SEGMENTAL ANCHOR PLUG CATALOG # 178402 LOT # 930680; COMPRESS TRANSVERSE PIN CATALOG # 178527 LOT # 785050; COMPRESS NUT CATALOG # 178512 LOT # 885860; COMPRESS CENTERING SLEEVE CATALOG # 178537 LOT # UNKNOWN; OSS DIAPHYSEAL LOCKING SCREW SET CATALOG # 150481 LOT # 133790; COMPRESS TAPER ADAPTER CATALOG # 178711 LOT # 755330; OSS DIAPHYSEAL STACKING ADAPTOR CATALOG # 150483 LOT # 975100; OSS DIAPHYSEAL SEGMENT CATALOG # 150465 LOT # 414310; OSS DIAPHYSEAL SEGMENT CATALOG # 150464 LOT # 556640; OSS AXLE CATALOG # 150480 LOT # 584290; OSS LOCKING PIN CATALOG # 150478 LOT # 210660. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED BECAUSE PRODUCT LOCATION IS UNKNOWN. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILLED FOR THIS EVENT: 0001825034-2018-09174, 0001825034-2018-09175, 0001825034-2018-09178, 0001825034-2018-09181, 0001825034-2018-09183, 0001825034-2018-09418, 0001825034-2018-09420, 0001825034-2018-09421, 0001825034-2018-09423, 0001825034-2018-09424, 0001825034-2018-09425, 0001825034-2018-09426, 0001825034-2018-09428, 0001825034-2018-09429, 0001825034-2018-09430, 0001825034-2018-09433. PRODUCT LOCATION IS UNKNOWN.

Description of Event or Problem · 1

IT WAS REPORTED THAT AFTER A PATIENT UNDERWENT A KNEE ARTHROPLASTY WITH A LIMB SALVAGE SYSTEM THE PATIENT WENT INTO DEEP FLEXION, AGAINST THE SURGEONS ORDERS, AND HEARD AN AUDIBLE POPPING NOISE. THE PATIENT UNDERWENT A REVISION, DURING WHICH IT WAS REPORTED THAT THE COMPRESS NUT WAS RE-TIGHTENED AND THE CONSTRUCT WAS RE-ASSEMBLED USING THE SAME METAL COMPONENTS WITH NEW POLYETHYLENE COMPONENTS. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
775879 COMPRESS ANTI-ROTATION SPINDLE HIP PROSTHESIS KWA ZIMMER BIOMET, INC. N/A 925600

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R