FDA Adverse Event Injury Summary report: N

FEMORAL STEM 12/14 NECK TAPER SIZE 13 138 MM STEM LENGTH CEMENTLESS

MDR report key: 14137879 · Received April 18, 2022

Report

Report Number
0001822565-2022-01126
Event Type
Injury
Date Received
April 18, 2022
Report Date
July 8, 2022
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LZO
UDI-DI
00889024139251
PMA / PMN Number
K200823
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). IMPLANT DATE: UNKNOWN DAY IN (B)(6) 2021. THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS, AS THE DEVICE REMAINS IMPLANTED; HOWEVER, AN INVESTIGATION OF THE REPORTED EVENT IS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A SUPPLEMENTAL MEDWATCH 3500A WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001822565 - 2022 - 01124 , 0002648920 - 2022 - 00098 , 0001822565 - 2022 - 01125.

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. H6: PROPOSED COMPONENT CODE: MECHANICAL (G04)- STEM. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. RADIOGRAPHS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING: RELATIVELY NORMAL APPEARANCE OF THE BILATERAL TOTAL HIP ARTHROPLASTIES. IT IS NOTED THAT THERE IS SLIGHT LATERAL ECCENTRIC POSITIONING OF THE FEMORAL TIPS IN BOTH OF THE ARTHROPLASTIES, NONSPECIFIC AND POTENTIALLY RELATED TO INITIAL SURGICAL TECHNIQUE. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. 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

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. D10: REF (B)(4). LOT 3011773 CERAMIC FEMORAL HEAD.

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED/CORRECTED UPDATED: H2; H6 NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. MEDICAL RECORDS WERE NOT PROVIDED. PART AND LOT IDENTIFICATION ARE NECESSARY FOR REVIEW OF DEVICE HISTORY RECORDS, NEITHER WERE PROVIDED. 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.

Description of Event or Problem · 0

IT WAS REPORTED THE PATIENT UNDERWENT A LEFT HIP PROCEDURE. SUBSEQUENTLY, THE PATIENT STATES TO HAVE HAD PAIN IN THE GROIN AND BOTH LEGS SINCE THE PROCEDURE. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE AT THIS TIME.

Description of Event or Problem · 0

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

Description of Event or Problem · 0

IT WAS REPORTED THE PATIENT UNDERWENT A LEFT HIP PROCEDURE. SUBSEQUENTLY, THE PATIENT STATES TO HAVE HAD PAIN IN THE GROIN AND BOTH LEGS SINCE THE PROCEDURE. THE DOCTOR TOLD THE PATIENT THAT THE IMPLANTS WERE INSTALLED CROOKED. NO REVISION HAS BEEN REPORTED TO DATE. 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.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1676965 FEMORAL STEM 12/14 NECK TAPER SIZE 13 138 MM STEM LENGTH CEMENTLESS PROSTHESIS, HIP LZO ZIMMER BIOMET, INC. N/A 64690149 00889024139251
2954933 FEMORAL STEM 12/14 NECK TAPER SIZE 13 138 MM STEM LENGTH CEMENTLESS PROSTHESIS, HIP LZO ZIMMER BIOMET, INC. N/A 64690149 00889024139251

Patients

Seq Age Sex Outcome Treatment
1 Male Other