FDA Adverse Event Injury Summary report: N

TESS GLENOID CEMENTED PE S3

MDR report key: 18317517 · Received December 13, 2023

Report

Report Number
3006946279-2023-00106
Event Type
Injury
Date Received
December 13, 2023
Date of Event
June 1, 2016
Report Date
February 19, 2025
Manufacturer
BIOMET FRANCE S.A.R.L.
Product Code
PHX
PMA / PMN Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

CMP-0909038 D10 - MEDICAL DEVICES: TESS HUM CENTRED HEAD 52MM; ITEM# P1700140; LOT# UNKNOWN. TESS HUM ANATOMICAL COROLLA S3; ITEM# P1700446; LOT# UNKNOWN. TESS HUM STEM SMALL; ITEM# P1700128; LOT# UNKNOWN. G2 - FOREIGN: FRANCE. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3006946279-2023-00107, 3006946279-2023-00108, 3006946279-2023-00109. THE PRODUCTS REMAIN IMPLANTED; THEREFORE, VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. A REVIEW OF THE DEVICE MANUFACTURING RECORDS COULD NOT BE PERFORMED DUE TO MISSING LOT NUMBER. DEVICES ARE USED FOR TREATMENT. MEDICAL RECORDS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. THE REVIEW IDENTIFIED THE EVACUATION OF HEMATOMA APPROXIMATELY SEVEN YEARS AND SIX MONTHS AGO. IMPLANTS REMAIN IMPLANTED. NO OTHER INFORMATION HAS BEEN FOUND. WITH THE AVAILABLE INFORMATION, A DEFINITIVE ROOT CAUSE COULD NOT BE DETERMINED. 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

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL AND/OR CORRECTED INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: D4 - PRIMARY UNIQUE DEVICE IDENTIFICATION (UDI) NUMBER IS NOT APPLICABLE AS THE LOT NUMBER OF THE DEVICE IS UNKNOWN. 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

IT WAS REPORTED THAT THE PATIENT DEVELOPED A HEMATOMA POST IMPLANTATION. A REOPERATION WAS SUBSEQUENTLY PERFORMED TWO DAYS POST IMPLANTATION TO EVACUATE THE HEMATOMA. NO IMPLANTS WERE EXPLANTED. NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

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
1580266 TESS GLENOID CEMENTED PE S3 SHOULDER PROSTHESIS PHX BIOMET FRANCE S.A.R.L. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 61 YR Male Hospitalization| R SEE H10 NARRATIVE