FDA Adverse Event Injury Summary report: N

VNGD PS OPEN INTL FEM RT 70

MDR report key: 8912834 · Received August 20, 2019

Report

Report Number
0001825034-2019-03719
Event Type
Injury
Date Received
August 20, 2019
Date of Event
August 31, 2018
Report Date
August 20, 2019
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JWH
PMA / PMN Number
K171054
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THIS EVENT WAS ORIGINALLY SENT UNDER MFR# 0001822565-2018-06501 AFTER RECEIVING ADDITIONAL INFORMATION, THIS EVENT WILL NOW BE SENT UNDER MFR# 0001825034-2019-03719. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2019-03712. CONCOMITANT MEDICAL PRODUCTS - VNGD PS TIB BRG 10X79/83MM, CATALOG#: 183660, LOT#: 081220; POLISHED FINNED TIB TRAY 83MM, CATALOG#: 141256, LOT#: 2018010134. REPORT SOURCE- (B)(6). REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DEVICE HISTORY RECORD WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT 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 · 1

IT WAS REPORTED THAT PATIENT UNDERWENT DEBRIDEMENT TO TREAT DELAYED WOUND HEALING TWO (2) MONTHS POST INITIAL SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
706354 VNGD PS OPEN INTL FEM RT 70 PROSTHESIS, KNEE JWH ZIMMER BIOMET, INC. N/A J6183609

Patients

Seq Age Sex Outcome Treatment
1 69 YR Hospitalization| R