FDA Adverse Event Injury Summary report: N

UNKNOWN BIOMET ARCOM 3 PEG PATELLA 31MM

MDR report key: 8028738 · Received November 1, 2018

Report

Report Number
0001825034-2018-10075
Event Type
Injury
Date Received
November 1, 2018
Date of Event
February 10, 2005
Report Date
November 1, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
NI
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 CRUCIATE RETAINING INTERLOK FEMORAL COMPONENT RIGHT 62.5MM CATALOG #: 183006 LOT #: NI, VANGUARD CRUCIATE RETAINING TIBIAL BEARING 16MM X 63MM/67MM CATALOG #: 183426 LOT #: NI, BIOMET CC I-BEAM TIBIAL TRAY 67MM CATALOG #: 141222 LOT #: NI. THE COMPLAINANT HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS THE LOCATION OF THE DEVICES IS UNKNOWN AT THIS TIME. THE COMPLAINT SAMPLE WAS NOT EVALUATED AND THE REPORTED EVENT COULD NOT BE CONFIRMED. A DEVICE HISTORY RECORD REVIEW WAS UNABLE TO BE PERFORMED AS THE LOT NUMBER OF THE DEVICE INVOLVED IN THE EVENT IS UNKNOWN. A 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 FILED FOR THIS PATIENT; PLEASE SEE ALL REPORTS ASSOCIATED WITH THIS EVENT: 1825034-2018-10072, 1825034-2018-10073, 1825034-2018-10074, 1825034-2018-10075. INSUFFICIENT INFORMATION.

Description of Event or Problem · 1

IT IS REPORTED THAT THE PATIENT WAS TREATED WITH KEFLEX ANTIBIOTICS TO ADDRESS ABSCESS FORMATION AND RUPTURE THAT DRAINED FROM THE SURGICAL SITE LESS THAN ONE MONTH FOLLOWING KNEE ARTHROPLASTY. NO ADDITIONAL PATIENT CONSEQUENCES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
870492 UNKNOWN BIOMET ARCOM 3 PEG PATELLA 31MM PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A NI

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention