FDA Adverse Event Injury Summary report: N

RINGLOC TI LOW PROFILE SCREW 6.5X25MM

MDR report key: 18897180 · Received March 13, 2024

Report

Report Number
0001825034-2024-00710
Event Type
Injury
Date Received
March 13, 2024
Date of Event
February 19, 2024
Report Date
July 10, 2024
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWA
PMA / PMN Number
K082446
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10: 11-103552, UNIV RNGLC SHL 52MM/L23, 352570. 163653 22.2MM, DIA COCR MOD HD -3MM NK, 107230. RD115915, ARCOM RNGLOC LNR LPW 22MM, 23 245490. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2024-00711. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: NO PRODUCT WAS RETURNED, OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. LOT IDENTIFICATION IS NECESSARY FOR REVIEW OF DEVICE HISTORY RECORDS, AND LOT IDENTIFICATION WAS NOT PROVIDED. THE REPORTED PRODUCTS WERE REVIEWED FOR COMPATIBILITY WITH NO ISSUES NOTED. MEDICAL RECORDS WERE NOT PROVIDED. THE REPORTED COMPLAINT COULD NOT BE CONFIRMED. 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 THE CUP WAS UNSTABLE DUE TO THE AGE OF THE IMPLANT. IMPLANT WAS TWENTY (20) YEARS OLD. SUBSEQUENTLY, PATIENT UNDERWENT A REVISION.

Description of Event or Problem · 0

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

Description of Event or Problem · 0

NO ADDITIONAL EVENT INFORMATION TO REPORT AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1018531 RINGLOC TI LOW PROFILE SCREW 6.5X25MM PROSTHESIS, HIPS KWA ZIMMER BIOMET, INC. N/A UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 45 YR Female Required Intervention| H SEE H10 NARRATIVE