FDA Adverse Event Malfunction Summary report: N

OSS 7CM SEGMENTAL FEMORAL LT

MDR report key: 8591337 · Received May 8, 2019

Report

Report Number
0001825034-2019-02125
Event Type
Malfunction
Date Received
May 8, 2019
Date of Event
April 17, 2019
Report Date
September 17, 2019
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JDI
PMA / PMN Number
K002757
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

(B)(4). CONCOMITANT MEDICAL PRODUCTS: BEARING COMPONENT CATALOG # 150410 LOT # 790350. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. DEVICE HISTORY RECORD WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. RADIOGRAPHS WERE NOT SUBMITTED TO MMI AS THEY PROVIDE LIMITED INFORMATION FOR REVIEW OF UNDATED IMAGES FOR INFECTION. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. 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

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

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: OSS MOD TIBIA CATALOG # UNKNOWN LOT # UNKNOWN, BEARING CATALOG # UNKNOWN LOT # 790350. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION AS THE HOSPITAL DOES NOT PERMIT. 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: 0001825034-2019-02124, 0001825034-2019-02126. 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 · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT AN INITIAL LEFT KNEE PROCEDURE ON UNKNOWN DATE. SUBSEQUENTLY, THE PATIENT WAS REVISED DUE TO INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
385582 OSS 7CM SEGMENTAL FEMORAL LT PROSTHESIS, KNEE JDI ZIMMER BIOMET, INC. N/A 803500

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R