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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. PERSONA PARTIAL KNEE ARTICULAR SURFACE LEFT MEDIAL SIZE C 10MM; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. PERSONA PARTIAL KNEE ARTICULAR SURFACE LEFT MEDIAL SIZE C 10MM; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Device Problems Adverse Event Without Identified Device or Use Problem (2993); Noise, Audible (3273)
Patient Problems Fall (1848); Pain (1994); Ambulation Difficulties (2544); Joint Laxity (4526)
Event Date 10/12/2021
Event Type  Injury  
Event Description
It was reported that the patient underwent a left unicompartmental knee arthroplasty revision to address medial collateral ligament sprain, continued pain and ligament instability following a fall approximately nine (9) months post-operatively.Initial operative notes noted no intraoperative complications.Revision operative notes noted the patient had worsening pain, increasing functional limitations and there was a concern for ligamentous instability.No intraoperative complications were noted.Attempts have been made; however, no additional information is available.
 
Manufacturer Narrative
(b)(4).D10 concomitant devices unknown persona partial knee femur size 1 catalog #: ni, lot #: ni.Unknown personal partial knee vivacit-e polyethylene articular surface 10mm catalog #: ni, lot #: ni.Unknown personal partial knee tibial tray size c catalog #: ni, lot #: ni.Unknown bone cement catalog #: ni, lot #: ni.The complainant has indicated that the product will not be returned to zimmer biomet for investigation, as the device was discarded.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.Multiple mdr reports were filed for this patient; please see all reports associated with this event: 0001825034-2023-02239.H3 other text : investigation incomplete.
 
Manufacturer Narrative
This follow-up report is being filed to relay additional information.D10 - concomitant devices - persona partial knee cemented femoral component size 1 left medial catalog #: 42558000101.Lot #: 64386211, persona partial knee cemented tibial component size c left medial catalog #: 42538000301.Lot #: 64468722, biomet bone cement r 1x40.Catalog #: 110035368.Lot #: 004aac2502.
 
Event Description
No further event information available at the time of this report.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Medical records provided were reviewed and the reported event was confirmed.The device history records were reviewed and no discrepancies were identified.A definitive root cause could not be determined with the information 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.
 
Event Description
No further event information available at the time of this report.
 
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Brand Name
PERSONA PARTIAL KNEE ARTICULAR SURFACE LEFT MEDIAL SIZE C 10MM
Type of Device
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer (Section G)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key17808648
MDR Text Key324151324
Report Number0001825034-2023-02240
Device Sequence Number1
Product Code HSX
UDI-Device Identifier00880304817951
UDI-Public(01)00880304817951(17)231031(10)64157519
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K161592
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Study,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date 12/15/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/25/2023
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Expiration Date10/31/2023
Device Model NumberN/A
Device Catalogue Number42518200310
Device Lot Number64157519
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received11/30/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured10/30/2018
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
Treatment
SEE H10 NARRATIVE.
Patient Outcome(s) Hospitalization; Required Intervention;
Patient Age47 YR
Patient SexFemale
Patient Weight118 KG
Patient EthnicityNon Hispanic
Patient RaceWhite
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