FDA Adverse Event Injury Summary report: N

G7 OSSEOTI ACETABULAR SHELL

MDR report key: 19116682 · Received April 16, 2024

Report

Report Number
0001825034-2024-00328
Event Type
Injury
Date Received
April 16, 2024
Report Date
April 16, 2024
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LPH
UDI-DI
00880304544222
PMA / PMN Number
K140669
Removal / Correction Number
NI
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2024-00329. D10: ITEM# 51-103140; LOT# 6626648. ITEM# 650-1057; LOT# 2958797. ITEM# 650-1068; LOT# 2965056. ITEM# 30103607; LOT# 64358597. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. DHR WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. RADIOGRAPHS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING: ACETABULI PROTRUSIO OF THE ACETABULAR COMPONENT WITH SUBSIDENCE OF THE FEMORAL COMPONENT AND DISLOCATION OF THE FEMORAL HEAD. FRACTURE SUPEROMEDIAL AND ANTERIOR ACETABULUM. 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 BY THE PMI GROUP THAT A PATIENT UNDERWENT A RIGHT HIP ARTHROPLASTY ON AN UNKNOWN DATE. SUBSEQUENTLY, THE PATIENT IS BEING CONSIDERED FOR A PMI PRODUCT ON AN UNKNOWN DAY FOR AN UNKNOWN REASON. X-RAYS RECEIVED AND REVIEWED, NOTING LOOSENING OF THE ACETABULAR COMPONENT, SUBSIDENCE OF THE FEMORAL COMPONENT, DISLOCATION OF THE FEMORAL HEAD, AND BONE FRACTURE OF THE ACETABULUM. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1125896 G7 OSSEOTI ACETABULAR SHELL PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER LPH ZIMMER BIOMET, INC. NI 6630992 00880304544222

Patients

Seq Age Sex Outcome Treatment
1 NA Male Other