FDA Adverse Event Injury Summary report: N

UNKNOWN OXFORD FEMORAL COMPONENT S L

MDR report key: 8919929 · Received August 22, 2019

Report

Report Number
3002806535-2019-00692
Event Type
Injury
Date Received
August 22, 2019
Date of Event
April 18, 2019
Report Date
September 18, 2019
Manufacturer
BIOMET UK LTD.
Product Code
NRA
PMA / PMN Number
P010014
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DHR REVIEW WAS UNABLE TO BE PERFORMED AS THE LOT NUMBER OF THE DEVICE INVOLVED IN THE EVENT IS UNKNOWN. ROOT CAUSE WAS UNABLE TO 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

IT HAS BEEN REPORTED BY THE HOSPITAL THAT A PATIENT UNDERWENT AN INITIAL LEFT KNEE REPLACEMENT SURGERY. SUBSEQUENTLY, A REVISION PROCEDURE WAS PERFORMED DUE TO PROGRESSION OF OA AND PAIN. DURING OPERATION BEARING WAS FOUND TO BE FRACTURED WITH METALLOSIS IN THE JOINT.

Additional Manufacturer Narrative · 1

(B)(4). REPORT SOURCE, FOREIGN - EVENT OCCURRED IN THE (B)(6). CUSTOMER HAS INDICATED THAT THE PRODUCT IS IN THE PROCESS OF BEING RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. ONCE THE INVESTIGATION IS COMPLETE, A SUPPLEMENTAL MDR WILL BE SUBMITTED. CONCOMITANT MEDICAL PRODUCTS: UNKNOWN OXFORD BEARING S4, CATALOG #: NOT REPORTED, LOT #: NOT REPORTED; UNKNOWN OXFORD TIBIAL COMPONENT S E, CATALOG #: NOT REPORTED, LOT #: NOT REPORTED . MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3002806535-2019-00691, 3002806535-2019-00693. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION IS COMPLETE, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem · 1

IT HAS BEEN REPORTED BY THE HOSPITAL THAT A PATIENT UNDERWENT AN INITIAL LEFT KNEE REPLACEMENT SURGERY. SUBSEQUENTLY, A REVISION PROCEDURE WAS PERFORMED DUE TO PROGRESSION OF OA AND PAIN. DURING OPERATION BEARING WAS FOUND TO BE FRACTURED WITH METALLOSIS IN THE JOINT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
716477 UNKNOWN OXFORD FEMORAL COMPONENT S L KNEE PROSTHESIS NRA BIOMET UK LTD. N/A N/A

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R