FDA Adverse Event Injury Summary report: N

OXF ANAT BRG RT MD SIZE 3 PMA

MDR report key: 8892734 · Received August 14, 2019

Report

Report Number
3002806535-2019-00679
Event Type
Injury
Date Received
August 14, 2019
Date of Event
May 23, 2016
Report Date
November 14, 2019
Manufacturer
BIOMET UK LTD.
Product Code
NRA
UDI-DI
05019279786213
PMA / PMN Number
P010014
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NM, US
Reporter Occupation
003

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 BY THE PATIENTS LEGAL COUNSEL THAT THE PATIENT SUFFERED UNKNOWN MEDICAL CONDITION POST OXFORD PARTIAL KNEE ARTHROPLASTY. THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF¿S COMPLAINT, AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: MEDICAL PRODUCT: OXF TWIN-PEG CMNTDFEM MD PMA, CATALOG #: 161469, LOT #: 034750; MEDICAL PRODUCT: OXF UNI TIB TRAY SZ D RM PMA, CATALOG #: 154725, LOT #: 077100; MEDICAL PRODUCT: OXF ANAT BRG RT MD SIZE 3 PMA, CATALOG #: 159575, LOT #: 380260. ASSOCIATED PRODUCTS: MEDICAL PRODUCT: 1/8 QUICK REL DRL STERILE 2PK, CATALOG #: 32-486265, LOT #: 772500; MEDICAL PRODUCT: OXF SAWBLADE STRYKER CMNTD 3PK, CATALOG #: 506298, LOT #: 962269. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3002806535-2019-00678, 3002806535-2019-00677. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION IS COMPLETE, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED BY THE PATIENTS LEGAL COUNSEL THAT THE PATIENT SUFFERED UNKNOWN MEDICAL CONDITION POST OXFORD PARTIAL KNEE ARTHROPLASTY. THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF¿S COMPLAINT, AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
686720 OXF ANAT BRG RT MD SIZE 3 PMA KNEE PROSTHESIS NRA BIOMET UK LTD. N/A 380260 05019279786213

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization