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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER ORTHOPAEDIC MFG. LTD. PERSONA PARTIAL KNEE TIBIAL COMPONENT CEMENTED SIZE F LEFT MEDIAL; PROSTHESIS, KNEE

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ZIMMER ORTHOPAEDIC MFG. LTD. PERSONA PARTIAL KNEE TIBIAL COMPONENT CEMENTED SIZE F LEFT MEDIAL; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Pain (1994); Swelling (2091); Osteolysis (2377)
Event Date 10/27/2020
Event Type  Injury  
Manufacturer Narrative
(b)(4).Concomitant medical devices - persona partial knee femoral component cemented size 3 left catalog #: 42558000301 lot #: 64234164, persona partial knee articular surface left medial size f 11mm catalog #: 42518200611 lot #: 63082772, unknown refobacin cement catalog #: ni lot #: ni.Report source - foreign: (b)(6).The complainant has not yet indicated whether the product will be returned to zimmer biomet for investigation.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.Investigation incomplete.
 
Event Description
It was reported that the patient underwent a left knee arthroplasty revision to address tibial osteolysis and pain approximately fifteen (15) months post-operatively.Attempts have been made and no additional information is available at this time.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Multiple mdr reports were filed for this patient; please see all reports associated with this event: 3007963827-2021-00003, 3007963827-2021-00025, 0001825034-2021-00346.
 
Event Description
It was reported that the patient underwent a left knee arthroplasty revision to address pain, swelling and tibial osteolysis approximately fifteen (15) months post-operatively.Initial operative notes did not identify any intraoperative complications.Revision operative notes reported removal of implants without bone loss with no loosening identified.New components were implanted and the surgery was completed without complications.Attempts have been made and no additional information is available at this time.
 
Manufacturer Narrative
Upon reassessment of the reported event, it was determined an mdr should not have been filed under the current mfr number.This event will be reported on 0001825034-2021-00923.
 
Event Description
No further event information available at the time of this report.
 
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Brand Name
PERSONA PARTIAL KNEE TIBIAL COMPONENT CEMENTED SIZE F LEFT MEDIAL
Type of Device
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER ORTHOPAEDIC MFG. LTD.
building no 2 east park
shannon industrial estate
shannon, county clare
EI 
MDR Report Key11117255
MDR Text Key225082793
Report Number3007963827-2021-00003
Device Sequence Number1
Product Code HSX
Combination Product (y/n)N
PMA/PMN Number
K161592
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Type of Report Initial,Followup,Followup
Report Date 03/24/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/05/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue Number42538000601
Device Lot Number64039053
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Date Manufacturer Received03/10/2021
Is This a Reprocessed and Reused Single-Use Device? No
Removal/Correction NumberN/A
Patient Sequence Number1
Treatment
SEE H10 NARRATIVE
Patient Outcome(s) Hospitalization; Required Intervention;
Patient Age50 YR
Patient Weight109
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