FDA Adverse Event Injury Summary report: N

M2A-MAGNUM PF CUP 50ODX44ID

MDR report key: 19447117 · Received June 3, 2024

Report

Report Number
0001825034-2024-01446
Event Type
Injury
Date Received
June 3, 2024
Date of Event
October 5, 2023
Report Date
September 12, 2024
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LPH
PMA / PMN Number
K101336
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED/CORRECTED UPDATED: B4 D6B: DEVICE NOT EXPLANTED G3 G6 H2 H6 H11 NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. MEDICAL RECORDS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING: AFTER UNDERGOING AN INITIAL RIGHT THA , THE PATIENT BEGAN EXPERIENCING PAIN AND DIFFICULTY AMBULATING WITH ELEVATED METAL IONS AND PSEUDOTUMOR. DURING THE REVISION, METALLOSIS WAS IDENTIFIED WITHIN THE JOINT WITH THE PSEUDOTUMOR. THE TRUNNION WAS CLEANED AND THE STEM REMAINED. THE HEAD AND ADAPTER WERE EXPLANTED AND REPLACED. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. THIS COMPLAINT WAS CONFIRMED BASED ON THE PROVIDED MEDICAL RECORDS. 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: 157444 ITEM NAME M2A-MAGNUM MOD HD SZ 44MM LOT # 297020. 11-104113 ITEM NAME MLRY-HD POR FMRL 13X170MM LOT # 042090. 139252 ITEM NAME M2A-MAGNUM 42- 50MM TPR INSRT-6 0/-6MMT1 LOT # 133250. THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS AS IT¿S LOCATION IS NOT KNOWN; HOWEVER, AN INVESTIGATION OF THE REPORTED EVENT IS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED.

Description of Event or Problem · 0

THERE IS NO UPDATE TO THE PRIOR EVENT DESCRIPTION PROVIDED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT A REVISION PROCEDURE 10 YEARS AND 9 MONTHS POST IMPLANTATION DUE TO PAIN, DIFFICULTY AMBULATING, ELEVATED METAL ION LEVELS AND A PSEUDOTUMOR. DURING THE REVISION SIGNIFICANT METALLOSIS WAS NOTED. THE STEM WAS FOUND TO HAVE SIGNIFICANT INGROWTH THEREFORE NOT EXPLANTED, THE HEAD WAS REVISED WITHOUT COMPLICATIONS. THERE IS NO ADDITIONAL INFORMATION AT THE TIME OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1838737 M2A-MAGNUM PF CUP 50ODX44ID PROSTHETIC, HIP LPH ZIMMER BIOMET, INC. N/A 395540

Patients

Seq Age Sex Outcome Treatment
1 59 YR Female Hospitalization| R PLEASE SEE H11