FDA Adverse Event Injury Summary report: N

UNKNOWN ARPE NECK

MDR report key: 8469043 · Received April 1, 2019

Report

Report Number
0001825034-2019-01492
Event Type
Injury
Date Received
April 1, 2019
Date of Event
March 6, 2019
Report Date
April 4, 2019
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWG
PMA / PMN Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NO
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

UPON RECEIPT OF ADDITIONAL INFORMATION, IT HAS BEEN DETERMINED THAT THIS DEVICE WAS REPORTED UNDER THE INCORRECT MANUFACTURING SITE. THE INITIAL REPORT WAS FORWARDED IN ERROR AND SHOULD BE VOIDED.

Description of Event or Problem · 0

NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Additional Manufacturer Narrative · 1

(B)(4). CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS THE DEVICE LOCATION IS UNKNOWN. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. UNIQUE IDENTIFIER (UDI) #: N/A. CONCOMITANT MEDICAL PRODUCTS: UNKNOWN ARPE CUP; UNKNOWN ARPE STEM. EVENT OCCURRED IN (B)(6). MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034 - 2019 - 01493; 0001825034 - 2019 - 01494.

Description of Event or Problem · 1

IT WAS REPORTED THAT APPROXIMATELY 1 YEAR POST IMPLANTATION, THE PATIENT UNDERWENT A REVISION OF A THUMB ARTHROPLASTY DUE TO PAIN, INSTABILITY, AND LOOSENING. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
261282 UNKNOWN ARPE NECK PROSTHESIS, THUMB KWG ZIMMER BIOMET, INC. N/A NI

Patients

Seq Age Sex Outcome Treatment
1 60 YR Hospitalization| R