MAUDE Adverse Event Report: BIOMET UK LTD. OXF ANAT BRG RT MD SIZE 4 PMA; KNEE PROSTHESIS

Model Number N/A

Device Problem Insufficient Information (3190)

Patient Problem Pain (1994)

Event Date 12/02/2019

Event Type  Injury  

Manufacturer Narrative

(b)(4).Concomitant medical products: medical product: oxf uni tib tray sz d rm pma catalog #: 154725 lot #: 437750, medical product: oxf twin-peg cmntd fem md pma catalog #: 161469 lot #: 015540.Multiple mdr reports were filed for this event, please see associated reports: 3002806535-2019-00944, 3002806535-2019-00945.The investigation is in process.Once the investigation is complete, a follow-up mdr will be submitted.

Event Description

It was reported that a patient underwent an initial right knee replacement procedure.Subsequently, a revision procedure due to tibia pain was performed.

Manufacturer Narrative

(b)(4).Concomitant medical products: medical product: oxf uni tib tray sz d rm pma, catalog #: 154725, lot #: 437750, medical product: oxf twin-peg cmntd fem md pma, catalog #: 161469, lot #: 015540.Multiple mdr reports were filed for this event, please see associated reports: 3002806535-2019-00944-1, 3002806535-2019- 00945-1.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.

Event Description

It has been reported that a patient underwent an initial right knee replacement procedure.Subsequently, a revision procedure due to tibia pain was performed.

• Brand Name: OXF ANAT BRG RT MD SIZE 4 PMA
• Type of Device: KNEE PROSTHESIS
• Manufacturer (Section D): BIOMET UK LTD.; waterton industrial estates; bridgend CF31 3XA; UK CF31 3XA
• MDR Report Key: 9502797
• MDR Text Key: 172380399
• Report Number: 3002806535-2019-00946
• Device Sequence Number: 1
• Product Code: NRA
• Combination Product (y/n): N
• PMA/PMN Number: P010014
• 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: 01/21/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 12/20/2019
• 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: 159576
• Device Lot Number: 943040
• Was Device Available for Evaluation?: No
• Was the Report Sent to FDA?: No
• Date Manufacturer Received: 12/24/2019
• 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