FDA Adverse Event Injury Summary report: N

CER BIOLOXD OPTION HD 36MM

MDR report key: 18474452 · Received January 9, 2024

Report

Report Number
3002806535-2024-00010
Event Type
Injury
Date Received
January 9, 2024
Report Date
January 19, 2024
Manufacturer
BIOMET UK LTD.
Product Code
LZO
UDI-DI
00887868271397
PMA / PMN Number
K200959
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10 ¿ MEDICAL DEVICES: CER OPT TYPE 1 TPR SLEVE 0MM; ITEM# 650-1066; LOT# 3048736. CER BIOLOXD OPTION HD 36MM; ITEM# 650-1057; LOT# 3103921. G7 OSSEOTI MULTIHOLE 56MM F; ITEM# 110010266; LOT# 65300747. TRILOGY BONE SCR 6.5X35; ITEM# 00-6250-065-35; LOT# J7258386. TRILOGY BONE SCR 6.5X25; ITEM# 00-6250-065-25; LOT# J7263672. 3.2MMX30MM RNGLC+ ACET DRL BIT; ITEM# 31-323230; LOT# 495410. G7 APICAL HOLE PLUG; ITEM# 010000994; LOT# 7130450. G7 VIT E 10DEG LNR 36MM F; ITEM# 30113606; LOT# 65312681. 3.2MMX40MM RNGLC+ ACET DRL BIT; ITEM# 31-323240; LOT# 457220. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3002806535-2024-00009. 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 ADDITIONAL AND/OR CORRECTED INFORMATION. LIMITED INVESTIGATIONS DO NOT NEED TO HAVE THE RAW MATERIAL CERTIFICATE, STERILIZATION CERTIFICATE, COMPLAINT HISTORY, PRODUCT HOLD/FIELD ACTION PULLED AND REVIEWED. ALSO, A REVIEW OF THE RISK MANAGEMENT FILE HAS NOT BEEN COMPLETED AS THE PRODUCT IS CONSIDERED UNRELATED TO THE REPORTED EVENT. COMPLAINTS ARE MONITORED PER SOP263 COMPLAINT TRENDING PROCESS. DEVICES ARE USED FOR TREATMENT. THE REPORTED PRODUCTS WERE REVIEWED FOR COMPATIBILITY WITH NO ISSUES NOTED. MEDICAL RECORDS WERE NOT PROVIDED. THE ROOT CAUSE OF THE REPORTED ISSUE IS UNRELATED TO THE ZIMMER BIOMET MEDICAL DEVICE. 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 BY THE PATIENT UNDERWENT A HIP ARTHROPLASTY SURGERY. SUBSEQUENTLY THE PATIENT IS BEING REVISED DUE TO A FALL AND POOR BONE QUALITY. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

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
554072 CER BIOLOXD OPTION HD 36MM PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER LZO BIOMET UK LTD. N/A 3103921 00887868271397

Patients

Seq Age Sex Outcome Treatment
1 Prefer Not To Disclose Required Intervention