FDA Adverse Event Malfunction Summary report: N

CER OPTION TYPE 1 TPR SLEVE +6

MDR report key: 16120213 · Received January 9, 2023

Report

Report Number
3002806535-2023-00010
Event Type
Malfunction
Date Received
January 9, 2023
Date of Event
December 13, 2022
Report Date
May 30, 2023
Manufacturer
BIOMET UK LTD.
Product Code
LZO
UDI-DI
00887868271489
PMA / PMN Number
K200959
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10: CER OPTION TYPE 1 TPR SLEVE +6 ITEM #650-1068 LOT #2911080; CER OPT TYPE 1 TPR SLEVE 0MM ITEM #650-1066 LOT #2020020470; +6MM MOD HD ENDO II TRIAL ITEM #31-401161 LOT #UNKNOWN; ACT ARTIC E1 HIP BRG 28X40MM ITEM #EP-200146 LOT #65690351; CER BIOLOXD OPTION HD 28MM ITEM #650-1055 LOT #3087400; CER OPTION TYPE 1 TPR SLEVE +3 ITEM #650-1067 LOT #276250; TLOC 133 MP SP TP1 BM SO 6.0 ITEM #51-118060 LOT #3954835; G7 OSSEOTI 3 HOLE SHELL 50MM D ITEM #110010243 LOT #R7224675A; G7 DUAL MOBILITY LINER 40MM D ITEM #110024462 LOT #506770. THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS; HOWEVER, AN INVESTIGATION OF THE REPORTED EVENT IS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A SUPPLEMENTAL MEDWATCH 3500A WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

(B)(4). FOREIGN SOURCE: AUSTRALIA. CONCOMITANT MEDICAL PRODUCTS: CER OPTION TYPE 1 TPR SLEVE +6 ITEM#650-1068 LOT#2911080. CER OPT TYPE 1 TPR SLEVE 0MM ITEM#650-1066 LOT#2020020470. +6MM MOD HD ENDO II TRIAL ITEM#31-401161 LOT# UNKNOWN. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3002806535-2023-00009, 3002806535-2023-00011. INVESTIGATION OF THIS INCIDENT IS CURRENTLY ONGOING. ONCE THE INVESTIGATION IS COMPLETED, A SUPPLEMENTAL MEDWATCH 3500A WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY CORRECTED INFORMATION.   THE FOLLOWING SECTIONS WERE UPDATED: B4, B5, G3, G6, H1, H2, H6, H10. UPON REASSESSMENT OF THE REPORTED EVENT, IT WAS DETERMINED A MEDWATCH REPORT SHOULD NOT HAVE BEEN FILED BECAUSE ITEM AND LOT NUMBER OF RETURNED PRODUCTS ETCHING IS NOT THAT OF THE REPORTED PRODUCTS WITHIN THE COMPLAINT. FURTHERMORE, THE ITEM NUMBERS ETCHED ONTO THE PARTS ARE NOT RECOGNIZED AS ZIMMER BIOMET PRODUCT NUMBERS. GIVEN THIS INFORMATION, THIS MEDWATCH WILL BE VOIDED.

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. REVIEW OF THE PHOTOGRAPHS PROVIDED BY THE HOSPITAL IDENTIFIED THAT AN ENDO TRIAL IS BEING USED DURING THE G7 SURGERY. THERE ARE SPECIFIC G7 TRIALS AVAILABLE FOR TRIALLING AND THE USE OF THE ENDO TRIALS IS CONSIDERED AS BEING OFF LABEL. NOTHING FURTHER CAN BE GAINED FROM REVIEW OF THE PHOTOGRAPHS. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING. DEVICES ARE USED FOR TREATMENT. THE REPORTED PRODUCTS WERE REVIEWED FOR COMPATIBILITY AND IT WAS DETERMINED THAT THE ENDO TRIAL IS NOT COMPATIBLE FOR TRIALLING A G7 DUAL MOBILITY CONSTRUCT. MEDICAL RECORDS WERE NOT PROVIDED. THE ROOT CAUSE OF THE REPORTED ISSUE IS ATTRIBUTED TO USE ERROR - NON INDICATED USE OF PRODUCT. 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

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

Description of Event or Problem · 0

IT WAS FOUND THAT TAPER SLEEVE DID NOT MATCH WITH CERAMIC HEAD DURING HIP SURGERY. IT WAS REPORTED THAT THIS WAS DUE TO THE +6MM TRIAL HEAD, AND THE +6MM SLEEVES NOT RECREATING THE SAME CONSTRUCT. NO CONSEQUENCES OR IMPACT TO THE PATIENT. DUE DILIGENCE IS IN PROGRESS FOR THIS COMPLAINT; TO DATE NO ADDITIONAL INFORMATION OR PRODUCT HAS BEEN RECEIVED.

Description of Event or Problem · 0

UPON REASSESSMENT OF THE REPORTED EVENT, IT WAS DETERMINED A MEDWATCH REPORT SHOULD NOT HAVE BEEN FILED BECAUSE ITEM AND LOT NUMBER OF RETURNED PRODUCTS ETCHING IS NOT THAT OF THE REPORTED PRODUCTS WITHIN THE COMPLAINT. FURTHERMORE, THE ITEM NUMBERS ETCHED ONTO THE PARTS ARE NOT RECOGNIZED AS ZIMMER BIOMET PRODUCT NUMBERS.   GIVEN THIS INFORMATION, THIS MEDWATCH WILL BE VOIDED.

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
2294577 CER OPTION TYPE 1 TPR SLEVE +6 PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER, CEMENTED OR NON-POROUS LZO BIOMET UK LTD. N/A 3066236 00887868271489

Patients

Seq Age Sex Outcome Treatment
1 Prefer Not To Disclose SEE H10 NARRATIVE| SEE H10 NARRATIVE