MAUDE Adverse Event Report: BIOMET UK LTD. OXF ANAT BRG RT LG SIZE 4 PMA; OXFORD PARTIAL KNEE SYSTEM

Model Number	N/A
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code	Pain (1994)
Date of Event	08/24/2021
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
(b)(4).Initial report: customer has indicated that the product has been discarded, therefore will not be returned to zimmer biomet for investigation.Concomitant medical products: medical product: oxf twin-peg cmntd fem lg pma, catalog #:161470, lot #: 915290.Medical product: oxf uni tib tray sz d rm pma, catalog #:154725, lot #: 734830.Multiple mdr reports were filed for this event, please see associated reports: 3002806535-2021-00373, 3002806535-2021-00374.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
Event or Problem Description
It was reported that a patient underwent an initial right knee arthroplasty on (b)(6) 2016.Subsequently, a revision procedure due to pain was performed on (b)(6) 2021.Attempts have been made but no further information has been provided at this time.
Additional Manufacturer Narrative
(b)(4) this final report is being submitted to relay additional information.The following sections were updated: b4, b5, g3, g6, h1, h2, h6, h10.Complaint summary: as the product has not been received, the investigation was limited to the information provided; a review of device history records and complaint history.In addition, we have not been provided with any supporting documentation which could provide additional information.The source of pain cannot be determined through the radiographs, as only ap radiographs provided, no ml view so a full assessment of size, position and alignment cannot be done.A review of the manufacturing history records confirms no abnormalities or deviations reported, (b)(4) and (b)(4) were issued for item 161470 and ncr0024 was issued for item 154725.A review of the complaint database over the last 3 years has found 4 complaints reported with the item 159583, 5 complaints reported with the item 161470 and 6 complaints reported with the item 154725 (including the initiating complaint).Without the opportunity to examine the complaint product, root cause cannot be determined due to insufficient information.Capa: no corrective or preventive action required at this time.Multiple mdr reports were filed for this event, please see associated reports: (b)(4) if any further information is found which would change or alter any conclusions or information, a supplemental will be submitted accordingly.Zimmer biomet will continue to monitor for trends.
Event or Problem Description
It was reported that a patient underwent an initial right knee arthroplasty on (b)(6) 2016.Subsequently, a revision procedure due to pain was performed on (b)(6) 2021.Attempts have been made but no further information has been provided at this time.

• Brand Name: OXF ANAT BRG RT LG SIZE 4 PMA
• Common Device Name: OXFORD PARTIAL KNEE SYSTEM
• Manufacturer (Section D): BIOMET UK LTD.; waterton industrial estates; bridgend CF31 3XA; UK CF31 3XA
• MDR Report Key: 12407103
• Report Number: 3002806535-2021-00372
• Device Sequence Number: 5292207
• Product Code: NRA
• UDI-Device Identifier: 05019279786299
• UDI-Public: (01)05019279786299(17)210518(10)159240
• Combination Product (Y/N): N
• Initial Reporter State: IN
• Initial Reporter Country: US
• PMA/510(K) Number: P010014
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2016
• Device Explanted Year: 2021
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: consumer,health professional
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date (Section B): 10/13/2021

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
• Operator of Device: Health Professional
• Device Expiration Date: 05/18/2021
• Device Model Number: N/A
• Device Catalogue Number: 159583
• Device Lot Number: 169240
• Was Device Available for Evaluation?: No
• Was the Report Sent to FDA?: No
• Initial Date Received by Manufacturer: 08/24/2021
• Supplement Date Received by Manufacturer: 10/13/2021
• Initial Report FDA Received Date: 09/01/2021
• Supplement Report FDA Received Date: 10/13/2021
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• If action reported to FDA under 21 USC 360i(g), list FDA-assigned Recall Number or include a statement: N/A
• Patient Sequence Number: 1
• Concomitant Medical Products and Therapy/Usage Dates: SEE H10 NARRATIVE; SEE H10 NARRATIVE
• Outcome Attributed to Adverse Event: Hospitalization; Required Intervention
• Patient Age: 65 YR