MAUDE Adverse Event Report: BIOMET UK LTD. UNKNOWN BEARING COMPONENT; KNEE PROSTHESIS

Model Number N/A

Device Problem Insufficient Information (3190)

Patient Problem No Information (3190)

Event Date 11/01/2019

Event Type  Injury  

Manufacturer Narrative

(b)(4).Concomitant medical products: unknown tibial component catalog #: not reported lot #: not reported, medical product: unknown femoral component catalog #: not reported lot #: not reported.Multiple mdr reports were filed for this event, please see associated reports: 3002806535-2019-00891, 3002806535-2019-00893.The investigation is in process.Once the investigation is complete, a follow-up mdr will be submitted.

Event Description

It was reported that patient underwent right knee arthroplasty on an unknown date, subsequently patient was revised due to unknown reason.

Event Description

It was reported that patient underwent right knee arthroplasty on an unknown date, subsequently patient was revised due to unknown reason.

Manufacturer Narrative

(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.

• Brand Name: UNKNOWN BEARING COMPONENT
• Type of Device: KNEE PROSTHESIS
• Manufacturer (Section D): BIOMET UK LTD.; waterton industrial estates; bridgend CF31 3XA; UK CF31 3XA
• MDR Report Key: 9368998
• MDR Text Key: 167789003
• Report Number: 3002806535-2019-00892
• Device Sequence Number: 1
• Product Code: HRY
• Combination Product (y/n): N
• PMA/PMN Number: N/A
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,health
• Type of Report: Initial,Followup
• Report Date: 12/11/2019

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?: No
• Device Operator: Health Professional
• Device Model Number: N/A
• Device Catalogue Number: N/A
• Was Device Available for Evaluation?: No
• Was the Report Sent to FDA?: No
• Initial Date Manufacturer Received: 11/04/2019
• Initial Date FDA Received: 11/25/2019
• Supplement Dates Manufacturer Received: 12/05/2019
• Supplement Dates FDA Received: 12/11/2019
• Is This a Reprocessed and Reused Single-Use Device?: No
• Removal/Correction Number: N/A
• Patient Sequence Number: 1
• Patient Outcome(s): Hospitalization; Required Intervention
• Patient Weight: 68