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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. VANGUARD CR ILOK FEMORAL LEFT; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. VANGUARD CR ILOK FEMORAL LEFT; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Device Problem Unstable (1667)
Patient Problem Limited Mobility Of The Implanted Joint (2671)
Event Date 10/23/2019
Event Type  Injury  
Manufacturer Narrative
(b)(4).Medical product: e1 vngd cr tib brg 71/75x10 x 10, catalog #: ep-183440, lot #: 192970; biomet cc cruciate tray 75mm mm, catalog #: 141234, lot #: j3081730; series a pat thn 34 3 peg no/wr, catalog #: 184786, lot #: unknown.Customer has indicated that the product will not be returned because product location is unknown.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.Multiple mdr reports were filled for this event: 0001825034-2020-02451, 0001825034-2020-02454.Product location is unknown.
 
Event Description
It was reported that patient underwent total left knee arthroplasty.Subsequently, the patient was revised due to implant failure, instability, worse interior flexion and extension.Further, the patient alleges the surgeon stated the knee was loose during the revision procedure.Attempt for further information has been made, but no further information has been provided.
 
Manufacturer Narrative
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.Device was not returned.Device history record (dhr) was reviewed and no discrepancies relevant to the reported event were found.Root cause was unable to be determined as the necessary information to adequately investigate the reported event was not provided.The contact was sent the investigation results.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
VANGUARD CR ILOK FEMORAL LEFT
Type of Device
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
MDR Report Key10195377
MDR Text Key197793112
Report Number0001825034-2020-02453
Device Sequence Number1
Product Code OIY
Combination Product (y/n)N
PMA/PMN Number
K113550
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type consumer,distributor,health p
Type of Report Initial,Followup
Report Date 10/12/2020
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 Date09/18/2023
Device Model NumberN/A
Device Catalogue Number183032
Device Lot Number633940
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 06/05/2020
Initial Date FDA Received06/25/2020
Supplement Dates Manufacturer Received10/08/2020
Supplement Dates FDA Received10/12/2020
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 Weight84
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