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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. UNKNOWN ORTHOPEDIC SALVAGE SYSTEM DIAPHYSEAL SEGMENT; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. UNKNOWN ORTHOPEDIC SALVAGE SYSTEM DIAPHYSEAL SEGMENT; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Device Problems Metal Shedding Debris (1804); Scratched Material (3020)
Patient Problem Tissue Damage (2104)
Event Type  Injury  
Manufacturer Narrative
(b)(4).Concomitant medical product: unknown orthopedic salvage system axle, catalog#: 161035 lot#: 159990.Unknown orthopedic salvage system bearing, catalog#: unknown lot#: unknown.Unknown orthopedic salvage system femoral, catalog#: unknown lot#: unknown.Unknown orthopedic salvage system tibial tray, catalog#: unknown lot#: unknown.Unknown orthopedic salvage system stem, catalog#: unknown lot#: unknown.Unknown orthopedic salvage system femoral bushing, catalog#: unknown lot#: unknown.Unknown orthopedic salvage system tibial bushing, catalog#: unknown lot#: unknown.Unknown orthopedic salvage system yoke, catalog#: unknown lot#: unknown.Unknown orthopedic salvage system pin, catalog#: unknown lot#: unknown.(b)(6).Customer has indicated that the product will not be returned to zimmer biomet for investigation, as product location is unknown.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.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.Multiple mdr reports were filed for this event, please see associated reports: 0001825034-2017-11060, 0001825034-2018-00246, 0001825034-2018-00247, 0001825034-2018-00248.
 
Event Description
It was reported that the patient underwent revision surgery due to unknown reasons.The bearing, assembly, and diaphyseal segment were removed and replaced.It was noted by the surgeon that the axle had a scratch in the portion that makes contact with the yoke.The surgeon further noted that there were no product issues and that the patient¿s tissue was colored black around the prosthesis.No additional patient consequences were reported.Attempts have been made and additional information on the reported event is unavailable at this time.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information. reported event was unable to be confirmed due to limited information received from the customer.Device history record review was unable to be performed as the lot number of the device involved in the event is unknown.Root cause was unable to be determined as the necessary information to adequately investigate the reported event was not provided.  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.Device not returned for evalauation.
 
Event Description
No further event information available at the time of this report.
 
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Brand Name
UNKNOWN ORTHOPEDIC SALVAGE SYSTEM DIAPHYSEAL SEGMENT
Type of Device
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
MDR Report Key7186619
MDR Text Key97120421
Report Number0001825034-2018-00249
Device Sequence Number1
Product Code JWH
Combination Product (y/n)N
PMA/PMN Number
PN/A
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Type of Report Initial,Followup
Report Date 11/29/2018
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? Yes
Device Operator Physician
Device Model NumberN/A
Other Device ID NumberN/A
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 12/18/2017
Initial Date FDA Received01/12/2018
Supplement Dates Manufacturer Received11/14/2018
Supplement Dates FDA Received11/29/2018
Is This a Reprocessed and Reused Single-Use Device? No
Removal/Correction NumberN/A
Patient Sequence Number1
Treatment
PROSTHESIS, KNEE; PROSTHESIS, KNEE
Patient Outcome(s) Hospitalization; Required Intervention;
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