FDA Adverse Event Injury Summary report: N

DELTA CER FEM HD 32/+6MM T1

MDR report key: 8992411 · Received September 11, 2019

Report

Report Number
3002806535-2019-00740
Event Type
Injury
Date Received
September 11, 2019
Date of Event
July 29, 2018
Report Date
December 13, 2019
Manufacturer
BIOMET UK LTD.
Product Code
NRA
PMA / PMN Number
N/A
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION IS COMPLETE, A FOLLOW-UP MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. MEDICAL PRODUCT: STANMORE LATERAL SZ 4 CATALOG #: 650-0943 LOT #: 2041864. MEDICAL PRODUCT: EXCEED CEMENTED MULLER E1 60 CATALOG #: EP-123260 LOT #: 3864690. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION IS COMPLETE, A FOLLOW-UP MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION IS COMPLETE, A FOLLOW-UP MDR WILL BE SUBMITTED.

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. 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

THE HOSPITAL REPORTED THAT A PATIENT UNDERWENT AN INITIAL HIP REPLACEMENT PROCEDURE. SUBSEQUENTLY, A REVISION PROCEDURE WAS PERFORMED DUE TO THE CERAMIC FEMORAL HEAD FRACTURING.

Description of Event or Problem · 0

THE HOSPITAL REPORTED THAT A PATIENT UNDERWENT AN INITIAL HIP REPLACEMENT PROCEDURE. SUBSEQUENTLY, A REVISION PROCEDURE WAS PERFORMED DUE TO THE CERAMIC FEMORAL HEAD FRACTURING.

Description of Event or Problem · 0

THE HOSPITAL REPORTED THAT A PATIENT UNDERWENT AN INITIAL HIP REPLACEMENT PROCEDURE. SUBSEQUENTLY, A REVISION PROCEDURE WAS PERFORMED DUE TO THE CERAMIC FEMORAL HEAD FRACTURING.

Description of Event or Problem · 0

THE HOSPITAL REPORTED THAT A PATIENT UNDERWENT AN INITIAL HIP REPLACEMENT PROCEDURE. SUBSEQUENTLY, A REVISION PROCEDURE WAS PERFORMED DUE TO THE CERAMIC FEMORAL HEAD FRACTURING.

Additional Manufacturer Narrative · 1

(B)(4). REPORT SOURCE, FOREIGN - EVENT OCCURRED IN THE (B)(6). CONCOMITANT MEDICAL PRODUCTS: MEDICAL PRODUCT: STANMORE LATERAL SZ 4, CATALOG #: NOT REPORTED, LOT #: NOT REPORTED; MEDICAL PRODUCT: EXCEED CEMENTED MULLER E1 60, CATALOG #: NOT REPORTED, LOT #: NOT REPORTED. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION IS COMPLETE, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT A PATIENT UNDERWENT AN INITIAL HIP REPLACEMENT PROCEDURE. SUBSEQUENTLY, A REVISION PROCEDURE WAS PERFORMED DUE TO THE CERAMIC FEMORAL HEAD FRACTURING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
791476 DELTA CER FEM HD 32/+6MM T1 KNEE PROSTHESIS NRA BIOMET UK LTD. N/A 2019020673

Patients

Seq Age Sex Outcome Treatment
1 70 YR Hospitalization| R