MAUDE MDR 6864203

MDR report key
6864203
Report number
0001822565-2017-06373
Event key
0
Event type
3
Date of event
2012-04-24
Date received
2017-09-14
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. CHRISTINA ARNT
Address
56 E. BELL DR. WARSAW IN 46582 US
Phone
574-574-5745
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1GENDER SOLUTIONS PATELLO-FEMORAL TROCHLEA COMPONENTPROSTHESIS, KNEEZIMMER BIOMET, INC.KRRN/A0059260120261183519R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-09-1401. H; 2. R

Event Narratives#

N

Patient 1

(B)(4). 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.

D

Patient 1

IT WAS REPORTED THAT PATIENT UNDERWENT A TOTAL KNEE REPLACEMENTS AND SUBSEQUENTLY THE LEFT KNEE WAS REVISED DUE TO LOOSENING.

N

Patient 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY CORRECTED AND ADDITIONAL INFORMATION. UPDATED: CORRECTED: REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DHR WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. IN THE PACKAGE INSERT, LOOSENING OR FRACTURE/DAMAGE OF THE PROSTHETIC KNEE COMPONENTS IS LISTED AS POSSIBLE ADVERSE EFFECTS. 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.

D

Patient 1

IT WAS REPORTED THAT PATIENT UNDERWENT BILATERAL PATELLA FEMORAL REPLACEMENTS, AND SUBSEQUENTLY THE RIGHT KNEE WAS REVISED DUE TO LOOSENING.