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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER SWITZERLAND MANUFACTURING GMBH NCB®, PERIPROSTHETIC FEMUR PLATE, DISTAL, RIGHT, 21 HOLES, 393 MM; TRAUMA PROSTHESIS

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ZIMMER SWITZERLAND MANUFACTURING GMBH NCB®, PERIPROSTHETIC FEMUR PLATE, DISTAL, RIGHT, 21 HOLES, 393 MM; TRAUMA PROSTHESIS Back to Search Results
Model Number N/A
Device Problems Fracture (1260); Material Twisted/Bent (2981)
Patient Problems Failure of Implant (1924); Malunion of Bone (4529)
Event Date 08/28/2022
Event Type  Injury  
Event Description
It was reported that patient underwent right knee revision surgery due to a non union event in unknown time frame post-op.During surgery it was discovered that the periprosthetic femur plate was bent/fractured.Due diligence is in progress for this complaint; to date no additional information or product has been received.
 
Manufacturer Narrative
(b)(4).Investigation of this incident is currently ongoing.Once the investigation is completed, a supplemental medwatch 3500a will be submitted.
 
Manufacturer Narrative
(b)(4).This follow-up report is being submitted to relay additional and/or corrected information.A review of the provided photographs confirms the plate has fractured.Lot identification is necessary for review of device history record lot identification was not provided.Device is used for treatment.Medical records were not provided.A definitive root cause cannot be determined.If any further information is found which would change or alter any conclusions or information, a supplemental report 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
NCB®, PERIPROSTHETIC FEMUR PLATE, DISTAL, RIGHT, 21 HOLES, 393 MM
Type of Device
TRAUMA PROSTHESIS
Manufacturer (Section D)
ZIMMER SWITZERLAND MANUFACTURING GMBH
sulzer allee 8
sulzer industrie park
winterthur 8404
SZ  8404
Manufacturer (Section G)
ZIMMER SWITZERLAND MANUFACTURING GMBH
sulzer allee 8
sulzer industrie park
winterthur 8404
SZ   8404
Manufacturer Contact
christina arnt
56 e. bell dr.
warsaw, IN 46582
5745273773
MDR Report Key15367781
MDR Text Key299357651
Report Number0009613350-2022-00444
Device Sequence Number1
Product Code HRS
UDI-Device Identifier00889024297593
UDI-Public(01)00889024297593
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K100111
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 10/19/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/07/2022
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Model NumberN/A
Device Catalogue Number0203264021
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received10/06/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention; Hospitalization;
Patient Age72 YR
Patient SexFemale
Patient Weight99 KG
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