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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. VNGD PS+ TIB BRG 20X71/75MM; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. VNGD PS+ TIB BRG 20X71/75MM; PROSTHESIS, KNEE Back to Search Results
Catalog Number 183750
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Damage to Ligament(s) (1952); Joint Laxity (4526)
Event Date 12/18/2023
Event Type  Injury  
Event Description
It was reported that a patient underwent an initial total knee arthroplasty on an unknown date.Subsequently, the patient underwent revision surgery due to instability and a deficient medial collateral ligament.The femoral components and articular surface were replaced without reported complication.It was reported that no further information is available.
 
Manufacturer Narrative
(b)(4).D10: medical product: van ps open intl fem-lt 65: catalog#183128, lot#324010; vanguard fem pegs set 2: catalog#183099, lot#ni; biomet offset tibial tray 75mm: catalog#141484, lot#ni; offset tib tray 2.5mm adaptor: catalog#141490, lot#ni; bmt splined knee stm 14x80: catalog#141614, lot#ni.Multiple mdr reports have been filed for this event.Please see associated reports: 0001825034-2024-00070; 0001825034-2024-00072.The customer has indicated that the product will not be returned to zimmer biomet for investigation per hospital policy.The investigation is in process.Upon completion of the investigation, a follow-up mdr will be submitted.H3 other text : see h10 narrative.
 
Event Description
No further event information at time of this report.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The followings sections have been updated: b4; b5; d6a; g3; h2; h10.The investigation is in process.Upon receipt of additional information or completion of the investigation, a follow-up mdr will be submitted.
 
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Brand Name
VNGD PS+ TIB BRG 20X71/75MM
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 Key18484732
MDR Text Key332561867
Report Number0001825034-2024-00071
Device Sequence Number1
Product Code JWH
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K113550
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 01/29/2024
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? No
Device Operator Health Professional
Device Expiration Date02/28/2011
Device Catalogue Number183750
Device Lot Number794070
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 12/18/2023
Initial Date FDA Received01/10/2024
Supplement Dates Manufacturer Received01/10/2024
Supplement Dates FDA Received01/31/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured02/09/2006
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
SEE H10 NARRATIVE.
Patient Outcome(s) Hospitalization; Required Intervention;
Patient SexFemale
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