FDA Adverse Event Injury Summary report: N

COMPR SRS MOD RGX AUG - LG

MDR report key: 19404209 · Received May 28, 2024

Report

Report Number
0001825034-2024-01367
Event Type
Injury
Date Received
May 28, 2024
Date of Event
February 6, 2024
Report Date
June 13, 2024
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWT
PMA / PMN Number
K111746
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
DA
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10: COMPR SRS PROX BDY - SM 58MM CAT#211216 LOT#NI. COMPR SRS IC SEG - 120MM CAT#211227 LOT#NI. COMPR SRS MOD RGX AUG - LG CAT#211229 LOT#NI. COMPR SRS MOD STEM - 9X75MM CAT#211258 LOT#NI. G2: DENMARK. 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 3500A WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. DURING THE INVESTIGATION PROCESS A REVIEW OF THE STERILE CERTIFICATIONS WERE REVIEWED AND FOUND TO BE CONFORMING WITH NO APPLICABLE DEVIATIONS. DEVICES WERE VERIFIED TO HAVE GONE THROUGH ACCEPTABLE STERILIZATION PROCESS FOLLOWING ISO/AAMI/ASTM & EU PUBLISHED GUIDELINES. THERE ARE MULTIPLE FACTORS THAT MAY CONTRIBUTE TO AN INFECTION THAT ARE OUTSIDE THE CONTROL OF ZIMMER BIOMET, SUCH AS EXTERNAL FACTORS, I.E. HOSPITAL/SURGICAL ENVIRONMENT, PROVIDER RELATED RISK FACTORS, AND/OR PATIENT COMORBIDITIES/RISK FACTORS. AS THERE ARE NO INDICATIONS OF A PRODUCT OR PROCESS ISSUES IDENTIFIED AFFECTING IMPLANT SAFETY OR EFFECTIVENESS, IMPLANTED PRODUCTS ARE NOT IDENTIFIED AS THE SOURCE OR CONTRIBUTING TO THE REPORTED INFECTION. 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. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034 - 2024 - 01365 0001825034 - 2024 - 01366 0001825034 - 2024 - 01368

Description of Event or Problem · 0

IT WAS REPORTED IN A STUDY THAT A PATIENT REQUIRED MEDICAL INTERVENTION APPROXIMATELY 2 WEEKS POST IMPLANTATION DUE TO INFECTION, WOUND DEHISCENCE, NECROSIS, AND DRAINAGE. THE PATIENT WAS PRESCRIBED VEPICOMBIN AND THE INFECTION WAS CONSIDERED RESOLVED THE FOLLOWING WEEK. ALL IMPLANTS REMAIN IMPLANTED. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE AT THIS TIME.

Description of Event or Problem · 0

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
663974 COMPR SRS MOD RGX AUG - LG PROSTHESIS, SHOULDER KWT ZIMMER BIOMET, INC. NI 154430

Patients

Seq Age Sex Outcome Treatment
1 NA Male Required Intervention