FDA Adverse Event Injury Summary report: N

M2A-MAGNUM MOD HD SZ 46MM 46MM

MDR report key: 18276881 · Received December 6, 2023

Report

Report Number
0001825034-2023-02806
Event Type
Injury
Date Received
December 6, 2023
Date of Event
July 27, 2023
Report Date
November 15, 2024
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWA
PMA / PMN Number
K042037
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED/CORRECTED: UPDATED: G3; H2; H3; H4; H6 H6: PROPOSED COMPONENT CODE: MECHANICAL (G04) - HEAD NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. COMPLAINT CONFIRMED BASED ON EVALUATION OF THE PROVIDED MEDICAL RECORDS. REVIEW OF THE DEVICE HISTORY RECORD(S) IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. MEDICAL RECORDS WERE PROVIDED AND REVIEWED AND IDENTIFIED THE FOLLOWING: TRUNNION CLEAN AND INTACT, STEM STABLE. METALLOSIS TISSUE REMOVED FROM BEHIND THE ACETABULAR COMPONENT. SEVERE OSTEOLYSIS AND DEFECTS WITHIN THE ACETABULUM NOTED, HYDROSET APPLIED. ALL ZB COMPONENTS REMOVED, REPLACED WITH COMPETITOR PRODUCTS. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. IT IS UNKNOWN IF THE OFF-LABEL USAGE WITH A COMPETITOR STEM CAUSED OR CONTRIBUTED TO THE EVENT. 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

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: D9; G3; H3. ONE CUP LOT# 607640, HEAD LOT# 983530, AND AN INSERT WERE RETURNED AND EVALUATED. UPON VISUAL INSPECTION THE CUP HAS DAMAGE TO THE POROUS COATING ALONG WITH CIRCULAR INDENTATION INSIDE OF THE INNER RADIUS. THE RETURNED HEAD HAS MULTIPLE WEAR LINES AND SCUFFING ON THE OUTER RADIUS. THE INSERT IS INSTALLED IN THE HEAD AND COULD NOT BE REMOVED FOR FURTHER EVALUATION. THE ROOT CAUSE IS UNCHANGED. EVENT IS CONFIRMED VIA RETURNED PRODUCT. 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

(B)(4). MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034 - 2023 - 02805, 0001825034 - 2023 - 02807. THE CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION AS ITS LOCATION IS UNKNOWN. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem · 0

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

Description of Event or Problem · 0

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

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS REVISED APPROXIMATELY THIRTEEN YEARS POST-IMPLANTATION DUE TO METALLOSIS. DURING THE REVISION, THE COMPETITOR STEM WAS FOUND STABLE AND WITHOUT COMPLICATIONS. WHEN THE ACETABULAR SHELL WAS REMOVED, METALLOSIS TISSUE WAS DEBRIDED, AND OSTEOLYTIC DEFECTS WERE FILLED WITH GRAFTING. THE ACETABULAR COMPONENTS WERE REPLACED WITH COMPETITOR PRODUCTS WITHOUT COMPLICATIONS. NO FURTHER INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
220813 M2A-MAGNUM MOD HD SZ 46MM 46MM PROSTHESIS, HIP KWA ZIMMER BIOMET, INC. N/A 983530

Patients

Seq Age Sex Outcome Treatment
1 NA Female Required Intervention| H