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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. VANGRD ANT STBLZD BRG 12X71; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. VANGRD ANT STBLZD BRG 12X71; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Loss of Range of Motion (2032)
Date of Event 11/30/2021
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that patient underwent a right knee manipulation under anesthesia approximately six weeks post-implantation due to stiffness.Attempts to obtain additional information have been made; however, no more is available.
 
Additional Manufacturer Narrative
(b)(4).Multiple mdr reports were filed for this event, please see associated reports: 0001825034-2022-00291, 0001825034-2022-00292, and 0001825034-2022-00293.Concomitant medical devices: vanguard cr interlok fem - rt 70 catalog#: 183012 lot#: j7092472.Series a pat std 31 3 peg catalog#: 184764 lot#: 356520.Biomet cc i-beam tray 71mm catalog#: 141223 lot#: j6819006.The device will not be returned for analysis, as it remains implanted; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental medwatch 3500a will be submitted.
 
Event or Problem Description
No further event information available at the time of this report.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.According to tabers medical dictionary ¿ manipulation of a joint is a mobilization technique, sometimes involving a rapid thrust or stretching of a joint, with or without anesthesia.With anesthesia is (mua).Per clinical orthropaedics and related research (how to treat the stiff total knee arthroplasty? a systematic review), mua is used to treat and resolve arthrofibrosis (scar tissue).This procedure is performed to increase articular motion and reduce chronic pain from arthrofibrosis.The indication for manipulation under anesthesia is related to limited range of motion and stiffness due to adhesions/scar tissue.
 
Event or Problem Description
No further event information available at the time of this report.
 
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Brand Name
VANGRD ANT STBLZD BRG 12X71
Common Device Name
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
Manufacturer (Section G)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
Manufacturer Contact
christina arnt
56 e. bell dr.
warsaw, IN 46582
5745273773
MDR Report Key13479412
Report Number0001825034-2022-00292
Device Sequence Number14818296
Product Code JWH
UDI-Device Identifier00880304437029
UDI-Public(01)00880304437029(17)251031(10)037770
Combination Product (Y/N)N
Initial Reporter StateIN
Initial Reporter CountryUS
PMA/510(K) Number
K171054
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2021
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Study,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 04/14/2022
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 Date10/31/2025
Device Model NumberN/A
Device Catalogue Number189062
Device Lot Number037770
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/14/2022
Supplement Date Received by Manufacturer02/16/2022
04/01/2022
Initial Report FDA Received Date02/08/2022
Supplement Report FDA Received Date03/10/2022
04/14/2022
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/31/2020
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
N/A
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
SEE H10
Outcome Attributed to Adverse Event Required Intervention; Hospitalization;
Patient SexFemale
Patient Weight85 KG
Patient RaceWhite
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