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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. ORTHOPAEDIC SALVAGE SYSTEM AXLE; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. ORTHOPAEDIC SALVAGE SYSTEM AXLE; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Device Problems Unstable (1667); Patient Device Interaction Problem (4001)
Patient Problems Failure of Implant (1924); Insufficient Information (4580)
Event Date 07/21/2023
Event Type  Injury  
Manufacturer Narrative
(b)(4).D10 - concomitant devices - orthopaedic salvage system poly lock pin catalog #: 150478 lot #: 395950, orthopaedic salvage system 4cm diaphyseal segment catalog #: 150482 lot #: 640430, orthopaedic salvage system cemented im stem 15mm x 150mm catalog #: 150369 lot #: 055900, orthopaedic salvage system 7cm segmental femoral component right catalog #: 150354 lot #: 782310, orthopaedic salvage system modular tibial baseplate 79mm catalog #: 150424 lot #: 689560, series a 3 peg patella thin 37mm x 8.6mm catalog #: 184788 lot #: 277320, orthopaedic salvage system polyethylene tibial bearing 16mm catalog #: 150412 lot #: 622440, orthopaedic salvage system reinforced yoke catalog #: 150493 lot #: 293580, orthopaedic salvage system polyethylene femoral bushings catalog #: 150477 lot #: 096430, orthopaedic salvage system polyethylene tibial bushing catalog #: 150476 lot #: 540910.The complainant has indicated that the product will not be returned to zimmer biomet for investigation, as the devices were 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: 0001825034-2023-01892, 0001825034-2023-01896, 0001825034-2023-01897, 0001825034-2023-01898, 0001825034-2023-01899, 0001825034-2023-01900, 0001825034-2023-01901, 0001825034-2023-01903, 0001825034-2023-01904, 0001825034-2023-01906.H3 other text : investigation incomplete.
 
Event Description
It was reported that the patient underwent a right knee arthroplasty revision to address post-operative instability and bone preservation.Attempts have been made, however, no additional information is available.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.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
ORTHOPAEDIC SALVAGE SYSTEM AXLE
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 Key17555756
MDR Text Key321229916
Report Number0001825034-2023-01905
Device Sequence Number1
Product Code JDI
UDI-Device Identifier00880304002487
UDI-Public(01)00880304002487(17)280722(10)942420
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K002757
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Distributor
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 12/19/2023
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 Model NumberN/A
Device Catalogue Number150480
Device Lot Number942420
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 07/24/2023
Initial Date FDA Received08/16/2023
Supplement Dates Manufacturer Received12/15/2023
Supplement Dates FDA Received12/19/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured07/22/2019
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) Required Intervention; Hospitalization;
Patient SexMale
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