BIOMET CC I-BEAM TRAY 75MM N/A 141224

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00 report with the FDA on 2012-05-31 for BIOMET CC I-BEAM TRAY 75MM N/A 141224 manufactured by Biomet Orthopedics.

Event Text Entries

[2972912] It was reported that patient underwent total knee arthroplasty on (b)(6) 2008. Subsequently, patient was revised in (b)(6) 2011 allegedly due to pain and infection. Operative notes indicate that the tibial plate and femoral stem were found to be loose during the revision procedure. This report is based on allegations set forth in plaintiff's complaint, and the allegations contained therein are unverified.
Patient Sequence No: 1, Text Type: D, B5


[10179222] This follow-up report is being filed to relay that the tibial tray and femoral stem were found to be loose during the revision procedure. This was unknown at the time of initial medwatch. There are warnings in the package insert that state that this type of event can occur: under possible adverse effects, number four states, "loosening or migration of the implants can occur due to loss of fixation, trauma, malalignment, bone resorption or excessive activity. " this follow-up report is number 1 of 2 mdrs filed for the same event (reference 1825034-2012-00722-1 / 00723-1).
Patient Sequence No: 1, Text Type: N, H10


[19785927] Event date - sometime in (b)(6) 2011. Explanted date - sometime in (b)(6) 2011. This report is based on allegations set forth in plaintiff's complaint, the allegations contained therein are unverified. Current information is insufficient to permit a conclusion as to the cause of the event. Review of device history records show that lot released with no recorded anomaly or deviation. There are warnings in the package insert that state that this type of event can occur: under possible adverse effects, number two states, "early or late postoperative infection and allergic reaction". Number fifteen states, "interoperative or postoperative bone fracture and/or postoperative pain" review of sterilization certification confirms device was sterilized in accordance with iso 11137-2. This report is number 1 of 4 mdrs filed for the same event (reference 1825034-2012-00722 / 00725).
Patient Sequence No: 1, Text Type: N, H10


[19846879] It was reported that patient underwent total knee arthroplasty on (b)(6), 2008. Subsequently, patient was revised in (b)(6) of 2011 due to pain and infection. This report is based on allegations set forth in plaintiff's complaint, and the allegations contained therein are unverified.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001825034-2012-00722
MDR Report Key2595116
Report Source00
Date Received2012-05-31
Date of Report2012-05-02
Date Mfgr Received2012-05-02
Device Manufacturer Date2008-06-30
Date Added to Maude2012-06-01
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMS. ANGELA DICKSON
Manufacturer Street56 E. BELL DRIVE
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal46582
Manufacturer Phone5743711021
Manufacturer G1BIOMET ORTHOPEDICS
Manufacturer Street56 E. BELL DRIVE
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal Code46582
Single Use3
Previous Use Code3
Removal Correction NumberN/A
Event Type3
Type of Report3

Device Details

Brand NameBIOMET CC I-BEAM TRAY 75MM
Generic NamePROSTHESIS, KNEE
Product CodeBSN
Date Received2012-05-31
Model NumberN/A
Catalog Number141224
Lot Number437840
ID NumberN/A
OperatorPHYSICIAN
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBIOMET ORTHOPEDICS
Manufacturer Address56 E. BELL DRIVE WARSAW IN 46582 US 46582


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization; 2. Required No Informationntervention 2012-05-31

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