FDA Adverse Event Injury Summary report: N

BONE SCR 6.5X25 SELF-TAP

MDR report key: 17744744 · Received September 14, 2023

Report

Report Number
0001822565-2023-02521
Event Type
Injury
Date Received
September 14, 2023
Date of Event
August 21, 2023
Report Date
January 19, 2024
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LPH
UDI-DI
00889024119819
PMA / PMN Number
K934765
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10: 00625006525 BONE SCREW SELFTAPPING 6.5 MM DIA. 25 MM LENGTH LOT# J7470733; 00625006525 BONE SCREW SELFTAPPING 6.5 MM DIA. 25 MM LENGTH LOT# J7470734 X2; 110010267 G7 OSSEOTI MULTIHOLE 58MM G LOT # 7196532; 11-301620 ARCOS 20X200MM CYL DIST LOT #032610; 11-301303 ARCOS CON SZ C STD 60MM LOT #632650; 010000820 G7 HI-WALL ARCOMXL LNR 36MM G LOT # 6588427; 11-107021 FREEDOM CONSTR HD 36MM T1 +9MM LOT # 620700; 010000985 G7 FREEDOM CONST E1 LNR 36MM G LOT # 7042237. G2: FOREIGN: MEXICO. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001822565 - 2023 - 02516, 0001822565 - 2023 - 02517, 0001822565 - 2023 - 02522. THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS AS IT¿S LOCATION IS NOT KNOWN; HOWEVER, AN INVESTIGATION OF THE REPORTED EVENT IS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED H3 OTHER TEXT : DEVICE WAS DISCARDED.

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. A REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING. MEDICAL RECORDS/RADIOGRAPHS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. A REVIEW OF THE AVAILABLE RECORDS IDENTIFIED FINDINGS OF THE REPORTED ISSUES: IMPRESSIONS: ABNORMAL APPEARANCE OF A RIGHT TOTAL HIP ARTHROPLASTY WITH POSSIBLE LOOSENING OF THE ACETABULAR CUP AND ASSOCIATED CEMENT WITH LATERAL MIGRATION OF THE ACETABULAR CONSTRUCT AND FEMORAL COMPONENT. ASSOCIATED HIP DISLOCATION POST REVISION. 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A REVISION OF UNKNOWN DEVICES, THE DOCTOR NOTED THAT THE ACETABULUM WAS NOT PREPARED CORRECTLY; THEREFORE, INSERTED THE CUP WITH FIXATION OF FOUR SCREWS. DURING THE ATTEMPTS OF REDUCTION, ENCOUNTERED DIFFICULTY AND UPON DELIVERY OF FORCE, LED TO ROTATION OF THE PRESS-FIT FEMORAL STEM. A CURVED STEM WAS THEN PLACED AND AS ADDITIONAL REDUCTION ATTEMPTS WERE MADE, THE STEM ALSO ROTATED, LEADING TO THE STEM BEING CEMENTED. IN THE PROCESS OF TESTING THE HIP, ONE EVENT OF DISLOCATION OCCURRED; THEREFORE, ADDITIONAL REDUCTION MANEUVERS WERE REPEATED. THE PROCEDURE WAS COMPLETED AND THE PATIENT WAS TRANSPORTED OUT OF THE OR. AFTER APPROXIMATELY 1 HOUR, THE PATIENT WAS RETURNED TO THE OR DUE TO DISLOCATION. THE LINER WAS REVISED TO A FREEDOM LINER AND WAS SUCCESSFULLY REDUCED WITHOUT DISLOCATION. SUBSEQUENTLY, DUE TO THE USE OF TENSILE FORCE, THE CUP DETACHED FROM THE ACETABULAR WALL AND THE PATIENT WAS HOSPITALIZED HIP PENDENT. THERE IS NO ADDITIONAL INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Description of Event or Problem · 0

THERE IS NO UPDATE TO THE PRIOR EVENT DESCRIPTION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2225776 BONE SCR 6.5X25 SELF-TAP PROSTHETIC, HIP LPH ZIMMER BIOMET, INC. N/A J7470734 00889024119819

Patients

Seq Age Sex Outcome Treatment
1 62 YR Male Hospitalization| R