FDA Adverse Event Injury Summary report: N

BIOLOX DELTA CER LNR 36MM F

MDR report key: 17405783 · Received July 27, 2023

Report

Report Number
3002806535-2023-00260
Event Type
Injury
Date Received
July 27, 2023
Date of Event
July 18, 2023
Report Date
October 20, 2023
Manufacturer
BIOMET UK LTD.
Product Code
LPH
UDI-DI
00887868271052
PMA / PMN Number
N/A
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. NO PRODUCT WAS RETURNED, BUT TWO PICTURES WERE PROVIDED AND ASSESSED. THE ARTICULATION SURFACE AND THE RIM OF THE LINER EXHIBIT WHAT APPEARS TO BE METAL TRANSFER MARKS OTHERWISE THERE IS NOTHING ELSE THAT CAN BE DRAWN FROM THE PHOTOS. A REVIEW OF THE DEVICE MANUFACTURING RECORDS CONFIRMED NO ABNORMALITIES OR DEVIATIONS. DEVICE IS USED FOR TREATMENT. MEDICAL RECORDS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. THE PATIENT UNDERWENT A LEFT TOTAL HIP ARTHROPLASTY DUE TO OSTEOARTHRITIS. SUBSEQUENTLY, THE PATIENT UNDERWENT A REVISION SURGERY DUE TO DISLOCATION. DURING THE REVISION PROCEDURE IMPINGEMENT AND SCAR TISSUE WERE ALSO NOTED. TWO X-RAYS FROM THE INITIAL SURGERY WERE PROVIDED AND REVIEWED, HOWEVER, THEY DO NOT ENHANCE THE INVESTIGATION OF REPORTED EVENT IN THIS COMPLAINT. WITH THE AVAILABLE INFORMATION A DEFINITIVE ROOT CAUSE CANNOT BE ESTABLISHED. 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.

Additional Manufacturer Narrative · 0

(B)(4). D10 - MEDICAL DEVICES: G7 BONEMASTER LTD ACET SHL; ITEM# 010000705; LOT# 6813056. BIOLOX OPTION, HEAD, XL, 36/+7, TAPER 12/14; ITEM# 00-8777-036-04; LOT# 3099768. G2 - FOREIGN: AUSTRALIA. 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.

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 THAT A PATIENT UNDERWENT LEFT HIP ARTHROPLASTY. APPROXIMATELY 2 YEARS LATER, A REVISION PROCEDURE WAS PERFORMED DUE TO DISLOCATION. DURING THE REVISION PROCEDURE IMPINGEMENT AND SCAR TISSUE WERE ALSO NOTED. THE CUP, HEAD, AND LINER WERE EXCHANGED WITHOUT ANY REPORTED COMPLICATIONS AND NO FURTHER INFORMATION IS KNOWN AT THIS TIME. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
637866 BIOLOX DELTA CER LNR 36MM F G7 CERAMIC LINER LPH BIOMET UK LTD. N/A 6839566 00887868271052

Patients

Seq Age Sex Outcome Treatment
1 64 YR Female Required Intervention| H