FDA Adverse Event Injury Summary report: N

UNIV RNGLC SHL 48MM/L22

MDR report key: 10385876 · Received August 10, 2020

Report

Report Number
0001825034-2020-03097
Event Type
Injury
Date Received
August 10, 2020
Date of Event
March 4, 2014
Report Date
November 24, 2020
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LPH
PMA / PMN Number
K921301
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. 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.

Additional Manufacturer Narrative · 0

CMP-(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. D11: 163638 28MM COCR MOD HD +6MM 206300 11-105902 ARCOM 28MM RNGLOC LNR HWALL 258460. 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.

Additional Manufacturer Narrative · 0

CMP-(B)(4). REPORTED EVENT WAS CONFIRMED BY REVIEW OF MEDICAL RECORDS. DEVICE HISTORY RECORD (DHR) WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. ROOT CAUSE WAS UNABLE TO BE DETERMINED. MEDICAL RECORDS IDENTIFIED THE FOLLOWING : THE PATIENT UNDERWENT A LEFT TOTAL HIP ARTHROPLASTY. THE PATIENT BEGAN EXPERIENCING INSTABILITY AND RECURRENT DISLOCATIONS AND UNDERWENT A REVISION PROCEDURE ON DURING WHEN, ZIMMER BIOMET COMPONENTS WERE IMPLANTED. THE PATIENT UNDERWENT ANOTHER REVISION PROCEDURE DUE TO FAILED HIP ARTHROPLASTY. THE PATIENT WAS SUFFERING FROM PAIN AND THERE WAS SIGNIFICANT BONE LOSS. MRI REVEALED OSTEOLYSIS IN THE HIP JOINT. THE SHELL WAS FOUND TO BE LOOSE AND TRAPPED IN THE ACETABULUM MEDIAL DEFECT. HETEROTOPIC OSSIFICATION HAD FORMED POSTERIORLY AROUND POSTERIOR INFERIOR AND SUPERIOR ASPECT OF THE SHELL. THE STEM WAS WELL FIXED BUT THERE WAS EXTENSIVE CALCAR RESORPTION AND PROXIMAL FEMUR RESORPTION BELOW THE COLLAR OF THE STEM. THE LEG LENGTH WAS NOT CORRECTED. HEAD, LINER AND CUP WERE REPLACED WITH NEW ZIMMER BIOMET COMPONENTS. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL REPORT WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT EXPERIENCED TRAUMTIC LEFT HIP INJURY AT AGE 14 AND HAD A CUP ARTHROPLASTY PERFORMED. NINE YEARS LATER, THE PATIENT TRIPPED AND FELL. THE FALL TRAMUA RESULTED IN A FULL LEFT HIP REPLACEMENT. THE PATIENT WAS REVISED SEVEN YEARS POST INITIAL FULL HIP REPLACEMENT DUE TO PAIN, RECURRENT DISLOCATIONS AND INSTABILITY. PATIENT REVISED AGAIN TWENTY FOUR YEARS POST FULL THA DUE TO PAIN AND PELVIC BONE FRACTURE. SHE WAS TOLD HER HIP STEM WAS TOO LONG AND SHE WALKED ON IT WRONG FOR YEARS CAUSING HER PELVIC TO SNAP. DURING THE REVISION HER SURGEON WAS UNABLE TO REMOVE THE STEM DUE TO IT BEING TOO DEEP. HE OPTED TO REVISE HER ACETABULAR SIDE TO COMPENSATE. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Description of Event or Problem · 0

NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Description of Event or Problem · 0

NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL DEVICES: ITEM #: UNKNOWN UNKNOWN HEAD LOT #: UNKNOWN; ITEM #: UNKNOWN, UNKNOWN LINER, LOT #: UNKNOWN; 166025 INTEGRAL REVISION 15X225MM LF 317640. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. THE PRODUCT LOCATION IS UNKNOWN. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034 - 2020 - 03096.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT LEFT TOTAL HIP ARTHROPLASTY AND WAS REVISED 17 YEARS LATER DUE TO PELVIC BONE FRACTURE. SHE WAS TOLD HER HIP STEM WAS TOO LONG AND SHE WALKED ON IT WRONG FOR YEARS CAUSING HER PELVIC TO SNAP. DURING THE REVISION HER SURGEON WAS UNABLE TO REMOVE THE STEM DUE TO IT BEING TOO DEEP. HE OPTED TO REVISE HER ACETABULAR SIDE TO COMPENSATE. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
852206 UNIV RNGLC SHL 48MM/L22 PROSTHESIS, HIP LPH ZIMMER BIOMET, INC. N/A 130300

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R