PARTIAL FEMUR CEMENTED SIZE 4 RIGHT MEDIAL N/A 42558000402

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2019-10-15 for PARTIAL FEMUR CEMENTED SIZE 4 RIGHT MEDIAL N/A 42558000402 manufactured by Zimmer Biomet, Inc..

Event Text Entries

[162668653] (b)(4). Customer has indicated that the product will not be returned to zimmer biomet for investigation, as the device remains implanted. The investigation is in process. Once the investigation has been completed, a follow-up mdr will be submitted. Dob: (b)(6). Concomitant medical products: 42538000502, partial tibia cemented, lot # 63881381, 42528200508, partial articular surface, lot # 63583930. Multiple mdr reports were filed for this event, please see associated reports: 3007963827 - 2019 - 00295, 0001822565 - 2019 - 04431.
Patient Sequence No: 1, Text Type: N, H10


[162668694] It was reported that approximately 1 year post implantation, the patient was treated for pain and instability. Attempts have been made and no further information has been provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001822565-2019-04430
MDR Report Key9193090
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2019-10-15
Date of Report2019-10-31
Date of Event2019-04-30
Date Mfgr Received2019-10-16
Device Manufacturer Date2017-01-09
Date Added to Maude2019-10-15
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. CHRISTINA ARNT
Manufacturer Street56 E. BELL DR.
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal46582
Manufacturer Phone5745273773
Manufacturer G1ZIMMER BIOMET, INC.
Manufacturer Street56 E. BELL DRIVE
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal Code46582
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePARTIAL FEMUR CEMENTED SIZE 4 RIGHT MEDIAL
Generic NamePROSTHESIS, KNEE
Product CodeHSX
Date Received2019-10-15
Model NumberN/A
Catalog Number42558000402
Lot Number63532896
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerZIMMER BIOMET, INC.
Manufacturer Address56 E. BELL DRIVE WARSAW IN 46582 US 46582


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2019-10-15

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