FDA Adverse Event Injury Summary report: N

36MM I.D. SIZE E NEUTRAL LINER

MDR report key: 19605531 · Received June 25, 2024

Report

Report Number
0001822565-2024-02119
Event Type
Injury
Date Received
June 25, 2024
Date of Event
February 15, 2024
Report Date
August 30, 2024
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LPH
UDI-DI
00889024518742
PMA / PMN Number
K190660
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10: CAT #: 00625006530 / BONE SCREW SELF-TAPPING 6.5 MM DIA. 30 MM LENGTH / LOT #: J7180079 UNKNOWN APICAL HOLE PLUG; CAT #: 010000663 / G7 PPS LTD ACET SHELL 52E / LOT #: 7205831; CAT #: 51-104130 / TPRLC 133 T1 PPS HO 13X146MM / LOT #: 7062049; CAT #: 650-0662 / DELTA CERAMIC FEM HD 36/+3MM / LOT #: 3095589. 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. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001822565-2024-02120, 0001825034-2024-01679, 0001825034-2024-01680, 3002806535-2024-00235. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. MEDICAL RECORDS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING: MOBILITY ISSUES AND PAIN WITH TEMPORARY RELIEF DUE TO MEDICATION. AN MRI WAS PERFORMED AND THE PATIENT WAS CONFIRMED TO HAVE NO LOOSENING, INFECTION, MALALIGNMENT, OR SURROUNDING FLUID COLLECTION. THE COMPLAINT IS CONFIRMED BASED ON THE EVALUATION OF THE PROVIDED MEDICAL RECORDS. DHR WAS REVIEWED AND NO DISCREPANCIES RELATED TO THE REPORTED EVENT WERE FOUND. 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 DURING A CLINICAL STUDY, AT THE 2 YEAR FOLLOW-UP APPOINTMENT, THE PATIENT HAD BEEN EXPERIENCING GROIN PAIN THAT RADIATES TO THE LATERAL HIP FOR THE LAST THREE MONTHS. SO FAR, THE PATIENT HAS BEEN TREATED THROUGH PAIN MANAGEMENT CLINIC VISITS WITH NARCOTIC PAIN MEDICATION AND MULTIPLE UNKNOWN INJECTS THAT RESULTS IN TEMPORARY PAIN RELIEF. ATTEMPTS HAVE BEEN MADE BUT 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
479973 36MM I.D. SIZE E NEUTRAL LINER PROSTHESIS, HIP LPH ZIMMER BIOMET, INC. NI 65255952 00889024518742

Patients

Seq Age Sex Outcome Treatment
1 NA Male Required Intervention SEE H11 NARRATIVE.