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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER MANUFACTURING B.V. PERSONA ALL POLY PATELLA; PROSTHESIS, KNEE

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ZIMMER MANUFACTURING B.V. PERSONA ALL POLY PATELLA; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Pain (1994); Neck Stiffness (2434); Limited Mobility Of The Implanted Joint (2671)
Event Date 05/11/2017
Event Type  Injury  
Manufacturer Narrative
(b)(4).Concomitant medical products: catalog number: 42502006402, lot number: 62763632, brand name: persona cr narrow femoral; catalog number: 42532006702, lot: number:63125357, brand name: persona stemmed tibia; catalog number: 42522000412, lot: number:62342598, brand name: persona articular surface.Multiple mdr reports were filed for this event, please see associated reports: 0001822565 -2018 -06673, 0001822565 -2018 -06674, 0001822565 -2018 -06675.Medical records were provided and reviewed by a health care professional.Review of the available records identified the following: no complication noted during primary surgery.Office visits notes stated that the patient experienced pain constantly and decreased in daily activities.Reported event was confirmed by review of medical records provided.Device history record was reviewed and no discrepancies were found.Root cause was unable to 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.Device remains implanted.
 
Event Description
It was reported that the patient is suffering from pain, stiffness and limited activity in daily life approximately 2 years post initial surgery.The surgeon stated this was not related to the device.No revision occurred, implant remains in patient.Attempt for further information has been made, but no further information has been provided.
 
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Brand Name
PERSONA ALL POLY PATELLA
Type of Device
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER MANUFACTURING B.V.
turpeaux industrial park
route #1 km 123.4 bldg #1
mercedita PR 00715
Manufacturer (Section G)
ZIMMER MANUFACTURING B.V.
turpeaux industrial park
route #1 km 123.4 bldg #1
mercedita PR 00715
Manufacturer Contact
christina arnt
56 e. bell dr.
warsaw, IN 46582
5745273773
MDR Report Key8950208
MDR Text Key156141645
Report Number0002648920-2019-00649
Device Sequence Number1
Product Code JWH
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K172524
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Reporter Occupation Physician
Type of Report Initial
Report Date 08/30/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/30/2019
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Expiration Date05/31/2023
Device Model NumberN/A
Device Catalogue Number42540000032
Device Lot Number63064362
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received08/27/2019
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured06/05/2015
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Removal/Correction NumberN/A
Patient Sequence Number1
Patient Outcome(s) Other;
Patient Age60 YR
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