FDA Adverse Event Injury Summary report: N

ARCOS TROCH CLAW LARGE 100MM

MDR report key: 19174119 · Received April 24, 2024

Report

Report Number
0001825034-2024-01065
Event Type
Injury
Date Received
April 24, 2024
Date of Event
April 14, 2024
Report Date
October 14, 2024
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWA
UDI-DI
00880304474246
PMA / PMN Number
K090757
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
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: 0001825034-2024-01066. THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. MEDICAL RECORDS/RADIOGRAPHS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. A REVIEW OF THE AVAILABLE RECORDS IDENTIFIED FINDINGS OF THE REPORTED ISSUES. IMPRESSIONS: RIGHT TOTAL HIP ARTHROPLASTY WITH INTERVAL LOOSENING OF THE LATERAL CLAW SECONDARY TO ROTATION OF THE GREATER TROCHANTER. THE EVENT WAS CONFIRMED BASED ON THE EVALUATION OF THE PROVIDED MEDICAL RECORDS. DHR WAS REVIEWED AND NO DISCREPANCIES RELATED TO THE REPORTED EVENT WERE FOUND. THE ROOT CAUSE OF THE REPORTED ISSUE IS ATTRIBUTED TO OFF-LABEL USE OF THE CLAW AND THREADED BOLT, PER PAGE 19 OF THE ARCOS BROACH SURGICAL TECHNIQUE 0530.2-GLBL-EN "ONCE THE TROCHANTERIC FIXATION OPTION HAS BEEN DETERMINED, COMPRESS THE AUXILIARY IMPLANT TO THE BONE FRAGMENT BY THREADING THE PLUNGER TIGHTLY AGAINST THE AUXILIARY IMPLANT USING THE 5.0 MM HEX DRIVER AND T-HANDLE IN THE TORQUE LIMITING POSITION". AS NOTED IN THE COMPLAINT DESCRIPTION A LARGE CLAW WAS FIXED WITH 1 BOLT, AND 2 WIRES DISTALLY, HOWEVER NO PROXIMAL FIXATION SINCE THERE WAS NO LESSER TROCHANTER FOR WIRE FIXATION. 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 #: 11-302130 / ARCOS LATERAL TROCH BOLT 30MM / LOT #: 760420. UNKNOWN WIRE X 2. G2: SWITZERLAND. THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS; HOWEVER, AN INVESTIGATION OF THE REPORTED EVENT IS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED/CORRECTED. UPDATED: B4; B5; G3; H2; H6. CORRECTED B3. THE ROOT CAUSE OF THE REPORTED ISSUE IS ATTRIBUTED TO OFF LABEL USE OF THE CLAW AND THREADED BOLT. PER IFU (INSTRUCTIONS FOR USE), ¿TIGHT FIXATION OF ALL NON-CEMENTED COMPONENTS AT THE TIME OF SURGERY IS CRITICAL TO THE SUCCESS OF THE PROCEDURE. EACH COMPONENT MUST PROPERLY PRESS FIT INTO THE HOST BONE WHICH NECESSITATES PRECISE OPERATIVE TECHNIQUE AND THE USE OF SPECIFIED INSTRUMENTS. BONE STOCK OF ADEQUATE QUALITY MUST BE PRESENT AND APPRAISED AT THE TIME OF SURGERY.¿ ADDITIONALLY, THE SURGICAL TECHNIQUE STATES "THE ARCOS MODULAR FEMORAL REVISION SYSTEM IS NOT DESIGNED FOR USE IN A FULLY UNSUPPORTED PROXIMAL FEMUR. BONE STOCK OF ADEQUATE QUALITY MUST BE PRESENT AND APPRAISED AT THE TIME OF SURGERY." AS REPORTED, THE CLAW WAS FIXED WITH 1 BOLT AND 2 WIRES DISTALLY, HOWEVER NO PROXIMAL FIXATION WITH A CABLE WAS PRESENT SINCE THERE WAS NO LESSER TROCHANTER FOR WIRE FIXATION, INDICATING THAT THERE WAS NOT ADEQUATE BONE STOCK PRESENT AND TIGHT FIXATION OF THESE NON-CEMENTED COMPONENTS COULD NOT BE ACHIEVED. 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

NO ADDITIONAL EVENT INFORMATION TO REPORT AT THIS TIME.

Description of Event or Problem · 0

IT WAS REPORTED A PATIENT UNDERWENT A HIP REVISION APPROXIMATELY ONE MONTH POST IMPLANTATION DUE TO A LOOSE CLAW, BOLT AND WIRES. THE STEM, HEAD AND CUP REMAIN IMPLANTED. THE LOOSE PARTS WERE REMOVED AND A PLATE WAS INSTALLED ON THE LATERAL SIDE TO SECURE FIXATION. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION IS AVAILABLE.

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
1083791 ARCOS TROCH CLAW LARGE 100MM PROSTHESIS, HIP KWA ZIMMER BIOMET, INC. NI 65688621 00880304474246

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention| H SEE H11 NARRATIVE