FDA Adverse Event Injury Summary report: N

OXF ANAT BRG LT X-SM SZ 5 PMA

MDR report key: 8001182 · Received October 24, 2018

Report

Report Number
3002806535-2018-01156
Event Type
Injury
Date Received
October 24, 2018
Date of Event
September 24, 2018
Report Date
January 29, 2019
Manufacturer
BIOMET UK LTD.
Product Code
NRA
PMA / PMN Number
P010014
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

(B)(4). REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DEVICE HISTORY RECORD (DHR) WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT UNDERWENT AN INITIAL KNEE PROCEDURE AND SUBSEQUENTLY THE PATIENT WAS REVISED DUE TO LATERAL COMPARTMENT COLLAPSE.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS - OXF UNI TIB TRAY SZ B LM PMA, ITEM 154720, LOT 317790. OXF TWIN-PEG CMNTD FEM XS PMA, ITEM 161467, LOT 3021395. THERAPY DATE - (B)(6) 2018. 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 REPORTS: 3002806535-2018-01154 AND 3002806535-2018-01155.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT AN INITIAL KNEE PROCEDURE AND SUBSEQUENTLY THE PATIENT WAS REVISED DUE TO LATERAL COMPARTMENT COLLAPSE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
840531 OXF ANAT BRG LT X-SM SZ 5 PMA KNEE PROSTHESIS NRA BIOMET UK LTD. 85320

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R