MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-01-26 for OXF ANAT BRG LT SM SIZE 5 PMA N/A 159542 manufactured by Biomet Uk Ltd..
[176373625]
(b)(4). Report source: (b)(6). The investigation is in process. Once the investigation has been completed, a follow-up mdr will be submitted.
Patient Sequence No: 1, Text Type: N, H10
[176373626]
It was reported that a patient underwent an initial left knee arthroplasty. Subsequently, the patient had a fall which resulted in a bearing dislocation. A bearing revision procedure was performed.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3002806535-2020-00040 |
| MDR Report Key | 9630436 |
| Report Source | COMPANY REPRESENTATIVE,HEALTH |
| Date Received | 2020-01-26 |
| Date of Report | 2020-02-20 |
| Date of Event | 2019-12-27 |
| Date Mfgr Received | 2019-02-13 |
| Device Manufacturer Date | 2015-01-08 |
| Date Added to Maude | 2020-01-26 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. CHRISTINA ARNT |
| Manufacturer Street | 56 E. BELL DR. |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal | 46582 |
| Manufacturer Phone | 5745273773 |
| Manufacturer G1 | BIOMET UK LTD. |
| Manufacturer Street | WATERTON INDUSTRIAL ESTATES |
| Manufacturer City | BRIDGEND CF313XA |
| Manufacturer Country | UK |
| Manufacturer Postal Code | CF31 3XA |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | N/A |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | OXF ANAT BRG LT SM SIZE 5 PMA |
| Generic Name | KNEE PROSTHESIS |
| Product Code | NRA |
| Date Received | 2020-01-26 |
| Model Number | N/A |
| Catalog Number | 159542 |
| Lot Number | 3490498 |
| Device Expiration Date | 2020-01-31 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BIOMET UK LTD. |
| Manufacturer Address | WATERTON INDUSTRIAL ESTATES BRIDGEND CF313XA UK CF31 3XA |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2020-01-26 |