FDA Adverse Event Injury Summary report: N

G7 DUAL MOBILITY ACETABULAR LINER 36MM B

MDR report key: 19033491 · Received April 3, 2024

Report

Report Number
0001825034-2024-00924
Event Type
Injury
Date Received
April 3, 2024
Date of Event
March 17, 2024
Report Date
July 11, 2024
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LPH
UDI-DI
00880304703483
PMA / PMN Number
K150522
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. VISUAL EXAMINATION OF THE PROVIDED PICTURES IDENTIFIED THE EXPLANTED BEARING, WITH BIO DEBRIS ON THE OUTER SPHERICAL SURFACE, AS WELL AS INSIDE THE BEARING. NO FURTHER EVALUATION CAN BE MADE. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. ASSESSED 2 IMAGES FOR MMI SUBMISSION AND IT WAS DETERMINED NOT TO SUBMIT IMAGES AT THIS TIME. THE 2 SLICES PROVIDE ONLY PARTIAL BONE AND IMPLANT VISIBILITY WHICH WOULD LIMIT THE RADIOLOGIST'S EVALUATION OF THE REPORTED EVENTS, AS WELL AS THERE IS ARTIFACT PRESENT AND INCOMPLETE VISIBILITY OF CERCLAGE WIRES AROUND THE FEMUR. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. IT WAS REPORTED THE PATIENT FELL, HOWEVER THE REASON FOR THE FALL IS UNKNOWN. THIS COMPLAINT CANNOT BE CONFIRMED. 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). D10: CAT# 010000700 LOT# 7120505 G7 BONEMASTER LTD ACET SHL 46B. CAT# 163652 LOT# 267420 22.2MM DIA COCR MOD HD -5 NK. CAT# 11-301300 LOT# 600400 ARCOS CON SZ A STD 50MM. G2: FOREIGN ¿ AUSTRALIA. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034 - 2024 - 00922. 0001825034 - 2024 - 00923. THE CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION AS IT REMAINS IMPLANTED. 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

IT WAS REPORTED THAT THE PATIENT WAS REVISED APPROXIMATELY TWO YEARS POST-IMPLANTATION DUE TO A FEMUR FRACTURE AND THE BEARING WAS DISASSOCIATED FROM THE LINER. ONLY THE BEARING WAS REVISED. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1783316 G7 DUAL MOBILITY ACETABULAR LINER 36MM B PROSTHESIS, HIP LPH ZIMMER BIOMET, INC. N/A 360930 00880304703483

Patients

Seq Age Sex Outcome Treatment
1 NA Female Hospitalization| R SEE H10 NARRATIVE