FDA Adverse Event Injury Summary report: N

G7 DUAL MOBILITY LINER 44MM F

MDR report key: 14148378 · Received April 19, 2022

Report

Report Number
0001825034-2022-00900
Event Type
Injury
Date Received
April 19, 2022
Date of Event
March 10, 2021
Report Date
May 25, 2022
Manufacturer
ZIMMER BIOMET, INC.
Product Code
PBI
PMA / PMN Number
K121874
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
DA
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). SOURCE: (B)(4). CATALOG NUMBER: 00801802802 LOT NUMBER:63916779 BRAND NAME: (B)(6). CATALOG NUMBER:00811400200 LOT NUMBER:64046654 BRAND NAME: (B)(6). CATALOG NUMBER:EP-200150 LOT NUMBER:211640 BRAND NAME: (B)(6). CATALOG NUMBER:010000665 LOT NUMBER: 6378239 BRAND NAME: (B)(6). CATALOG NUMBER:110024464 LOT NUMBER: 857020 BRAND NAME: (B)(6). MULTIPLE REPORTS WERE SUBMITTED ALONG WITH THIS REPORT 0001825034-2022-00899. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

UPON REASSESSMENT OF THE REPORTED EVENT, IT WAS DETERMINED THAT THE EVENT IS NOT REPORTABLE AS THERE WAS AN ERROR IN HOSPITAL REPORTING, AND THE METAL LEVELS WERE NOT ELEVATED. ADDITIONAL INFORMATION RECEIVED INDICATED THAT THE HOSPITAL LAB INITIALLY REPORTED THE COBALT LEVELS IN THE UNIT NMOL/L, INSTEAD OF UG/L. CORRECT CONVERSIONS FOUND THAT THE PATIENT DID NOT HAVE ELEVATED COBALT LEVELS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT EXPERIENCED ELEVATED METAL ION LEVELS APPROXIMATELY 2 YEARS POST IMPLANTATION. HOWEVER, NO REVISION HAS BEEN REPORTED TO DATE. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE AT THIS TIME.

Description of Event or Problem · 0

UPON REASSESSMENT OF THE REPORTED EVENT, IT WAS DETERMINED THAT THE EVENT IS NOT REPORTABLE AS THERE WAS AN ERROR IN HOSPITAL REPORTING, AND THE METAL LEVELS WERE NOT ELEVATED. ADDITIONAL INFORMATION RECEIVED INDICATED THAT THE HOSPITAL LAB INITIALLY REPORTED THE COBALT LEVELS IN THE UNIT NMOL/L, INSTEAD OF UG/L. CORRECT CONVERSIONS FOUND THAT THE PATIENT DID NOT HAVE ELEVATED COBALT LEVELS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1409850 G7 DUAL MOBILITY LINER 44MM F PROSTHESIS, HIP PBI ZIMMER BIOMET, INC. N/A 857020

Patients

Seq Age Sex Outcome Treatment
1 Female Hospitalization| O