FDA Adverse Event Injury Summary report: N

TMJ SYSTEM RIGHT STANDARD MANDIBULAR COMPONENT

MDR report key: 8679478 · Received June 7, 2019

Report

Report Number
0001032347-2019-00312
Event Type
Injury
Date Received
June 7, 2019
Date of Event
February 11, 2019
Report Date
August 16, 2019
Manufacturer
BIOMET MICROFIXATION
Product Code
LZD
UDI-DI
00841036036430
PMA / PMN Number
P020016
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. SINCE THERE WAS A REVISION TO REMOVE AND REPLACE THESE PARTS, THE COMPLAINT IS CONFIRMED. THERE IS NO INDICATION OF MANUFACTURING DEFECTS. 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 REPORT WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Description of Event or Problem · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: TMJ SYSTEM LEFT STANDARD MANDIBULAR COMPONENT CATALOG # : 24-6546 LOT #: 143340; ZIMMER BIOMET TMJ SYSTEM RIGHT FOSSA COMPONENT, SMALL CATALOG # : 24-6562 LOT #: 284560; ZIMMER BIOMET ZIMMER BIOMET TMJ SYSTEM LEFT FOSSA COMPONENT, MEDIUM CATALOG # : 24-6561 LOT #: 071560; UNKNOWN SCREWS CATALOG#: NI LOT#: NI. 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: 0001032347-2019-00313, 0001032347-2019-00314, 0001032347-2019-00315.

Description of Event or Problem · 1

IT WAS REPORTED THAT A REVISION WAS PERFORMED IN WHICH THE TMJ IMPLANTS WERE REMOVED AND REPLACED WITH NEW IMPLANTS ELEVEN YEARS POST-IMPLANTATION. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED. NO ADDITIONAL PATIENT CONSEQUENCES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
474251 TMJ SYSTEM RIGHT STANDARD MANDIBULAR COMPONENT JOINT, TEMPOROMANDIBULAR, IMPLANT LZD BIOMET MICROFIXATION N/A 190800 00841036036430

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R