FDA Adverse Event Injury Summary report: N

COBALT CHROME FEMORAL HEAD 542 DIAMETER 22,2/ 12-14/ +2/ L

MDR report key: 11593995 · Received March 31, 2021

Report

Report Number
3006946279-2021-00045
Event Type
Injury
Date Received
March 31, 2021
Date of Event
July 28, 2020
Report Date
May 28, 2021
Manufacturer
BIOMET FRANCE S.A.R.L.
Product Code
JDI
PMA / PMN Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

(B)(4) THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTION HAS BEEN UPDATED : B4, B5, G3, G6, H1, H2, H6 AND H10. THE PRODUCT ANALYSIS CAN'T BE PERFORMED AS THE PRODUCT WAS NOT RETURNED (REMAINS IMPLANTED). THE DEVICE MANUFACTURING QUALITY RECORD INDICATES THAT THE RELEASED PRODUCT MET ALL REQUIREMENTS TO PERFORM AS INTENDED. RESULTS FROM MICROBIOLOGY ANALYSIS WERE RECEIVED, AND ALLOWED TO CONFIRM THE REPORTED INFECTION. ACCORDING TO THESE RESULTS, THE REPORTED EVENT WAS DUE TO BACTERIAL INFECTION TO STAPHYLOCOCCUS EPIDERMIDIS, WHICH IS A NORMAL COLONIZER OF THE SKIN. COMPLAINT EXTRACT WAS DONE REGARDING MEDICAL INFECTION: - 1 COMPLAINT (1 PRODUCT), THIS ONE INCLUDED, HAS BEEN RECORDED ON COCR FM HD D22,2/ 12-14/ +2/ L, REFERENCE (B)(4), FROM 01-JAN-2018 TO 26-MAR-2021. - 1 COMPLAINT (1 PRODUCT), THIS ONE INCLUDED, HAS BEEN RECORDED ON COCR FM HD D22,2/ 12-14/ +2/ L, REFERENCE (B)(4), BATCH J6382918, SINCE EVER INVESTIGATION RESULTS CONCLUDED THAT THE REPORTED EVENT WAS DUE TO BACTERIAL INFECTION TO STAPHYLOCOCCUS EPIDERMIDIS, WHICH IS A NORMAL COLONIZER OF SKIN. THERE IS NO EVIDENCE THAT THE EVENT IS RELATED TO THE PRODUCT. THE COMPLAINT IS CLOSED BUT COULD BE REOPENED IF NEW INFORMATION IS RECEIVED LATER. 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS RECEIVED ON 28-JUL-2020 AT THE CLINIC AND UNDERWENT ON 29-JUL-2020 A CLEANING AND WASHING OF THE JOINT FOLLOWING A BACTERIAL INFECTION TO STAPHYLOCOCCUS EPIDERMIDIS, WHICH IS A NORMAL COLONIZER OF SKIN.

Additional Manufacturer Narrative · 1

(B)(4). REPORT SOURCE, FOREIGN - EVENT OCCURRED IN (B)(6). LIST OF ASSOCIATED DEVICES: AVANTAGE INLAY S44 / 22,2 ; ITEM # P0560044; LOT # 0001439499; MANUFACTURED BY ZB VALENCE. AVANTAGE RELOAD CUP TI HA S44; ITEM #P0460P44; LOT # 0001219576; MANUFACTURED BY ZB VALENCE. EXCEPTION STD STEM LEFT SIZE 1; ITEM #PS125Y01; LOT #0001270155; MANUFACTURED BY ZB VALENCE. THE DEVICE MANUFACTURING QUALITY RECORDS ALL INDICATE THAT THE RELEASED PRODUCTS MET ALL REQUIREMENTS TO PERFORM AS INTENDED. THE INVESTIGATION IS IN PROGRESS. 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.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT WAS RECEIVED ON (B)(6) 2020 AT THE CLINIC AND UNDERWENT ON (B)(6) 2020 A CLEANING AND WASHING OF THE JOINT FOLLOWING A BACTERIAL INFECTION TO STAPHYLOCOCCUS EPIDERMIDIS, WHICH IS A NORMAL COLONIZER OF SKIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
493194 COBALT CHROME FEMORAL HEAD 542 DIAMETER 22,2/ 12-14/ +2/ L METALLIC FEMORAL HEAD PROSTHESIS JDI BIOMET FRANCE S.A.R.L. J6382918

Patients

Seq Age Sex Outcome Treatment
1 83 YR Hospitalization| R ASSOCIATED DEVICES LISTED IN SECTION H10.| ASSOCIATED DEVICES LISTED IN SECTION H10.