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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. VANGUARD PS TIB BEARING 10X87/91MM; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. VANGUARD PS TIB BEARING 10X87/91MM; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Device Problems Fracture (1260); Unstable (1667)
Patient Problems Failure of Implant (1924); No Information (3190)
Event Date 10/22/2020
Event Type  Injury  
Manufacturer Narrative
(b)(4).Foreign (b)(6).Customer has indicated that the product is in process of being returned to zimmer biomet for investigation.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event Description
It was reported that the patient had a revision procedure 32 months¿ post implantation due to a fractured tibial bearing while manually pulling a heavy trailer.Attempts have been made and no further information has been provided.
 
Manufacturer Narrative
(b)(4), visual examination of the returned product identified signs of being implanted wear/discoloration and the post has fractured off.The post fracture on the item was the result of overloading, possibly exacerbated by impingement from the femoral component, and possibly also exacerbated by misalignment of the femoral with the tibial component.Review of the device history records identified no deviations or anomalies during manufacturing.Radiographs were provided and reviewed by a health care professional.Review of the available records identified the following: the complaint is for the cam breaking off of the ps bearing.A definitive root cause cannot be determined.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 PS TIB BEARING 10X87/91MM
Type of Device
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
MDR Report Key11266538
MDR Text Key229856540
Report Number0001825034-2021-00307
Device Sequence Number1
Product Code JWH
UDI-Device Identifier00880304272095
UDI-Public(01)00880304272095(17)200620(10)369590
Combination Product (y/n)N
PMA/PMN Number
K113550
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,distri
Type of Report Initial,Followup
Report Date 04/07/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/02/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date06/20/2020
Device Model NumberN/A
Device Catalogue Number183680
Device Lot Number369590
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/12/2021
Was the Report Sent to FDA? No
Date Manufacturer Received04/07/2021
Is This a Reprocessed and Reused Single-Use Device? No
Removal/Correction NumberN/A
Patient Sequence Number1
Patient Outcome(s) Hospitalization; Required Intervention;
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