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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER MANUFACTURING B.V. ALL-POLY PATELLA CEMENTED 32 MM DIAMETER; PROSTHESIS, KNEE

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ZIMMER MANUFACTURING B.V. ALL-POLY PATELLA CEMENTED 32 MM DIAMETER; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Device Problems Fracture (1260); Unstable (1667)
Patient Problems Failure of Implant (1924); Pain (1994)
Event Date 07/18/2023
Event Type  Injury  
Manufacturer Narrative
(b)(4).D6a: 2019.Report source foreign - australia.The customer has indicated that the product is in process of being returned to zimmer biomet for investigation.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: 0001822565-2023-02102.
 
Event Description
It was reported that the patient underwent a revision approximately 4 years post implantation due to instability and pain.After opening the joint, the patella implant appeared to be fractured.This was resurfaced with a larger patella.The poly was exchanged for a thicker option to stabilize the knee joint.It was reported that wear was noted on the poly post and medial/lateral wells.Attempts have been made and no further information has been provided.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Visual examination of the provided pictures identified the patella implant as fractured.The articular surface was identified as worn with nicks and gouges on the post and distal surface.The device history record was reviewed and no discrepancies relevant to the reported event were found.A definitive root cause cannot be determined.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.
 
Event Description
No further event information available at the time of this report.
 
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Brand Name
ALL-POLY PATELLA CEMENTED 32 MM DIAMETER
Type of Device
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER MANUFACTURING B.V.
turpeaux industrial park
route #1 km 123.4 bldg #1
mercedita PR 00715
Manufacturer (Section G)
ZIMMER MANUFACTURING B.V.
turpeaux industrial park
route #1 km 123.4 bldg #1
mercedita PR 00715
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key17480193
MDR Text Key320591192
Report Number0002648920-2023-00181
Device Sequence Number1
Product Code MBH
UDI-Device Identifier00889024247697
UDI-Public(01)00889024247697(17)231031(10)64197144
Combination Product (y/n)N
Reporter Country CodeAS
PMA/PMN Number
K172524
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 11/14/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date10/31/2023
Device Model NumberN/A
Device Catalogue Number42540200032
Device Lot Number64197144
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 07/18/2023
Initial Date FDA Received08/08/2023
Supplement Dates Manufacturer Received11/10/2023
Supplement Dates FDA Received11/14/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured11/30/2018
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Removal/Correction NumberN/A
Patient Sequence Number1
Patient Outcome(s) Hospitalization; Required Intervention;
Patient SexPrefer Not To Disclose
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