BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BONE SCREW SELF-TAPPING 6.5 MM DIA. 50 MM LENGTH

    MDR report key: 19906400 · Received August 5, 2024

    Report

    Report Number
    0002648920-2024-00245
    Event Type
    Injury
    Date Received
    August 5, 2024
    Report Date
    January 15, 2025
    Manufacturer
    ZIMMER MANUFACTURING B.V.
    Product Code
    LPH
    UDI-DI
    00889024119857
    PMA / PMN Number
    K934765
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    LA, US
    Reporter Occupation
    PHYSICIAN
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    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. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING. THE REPORTED PRODUCTS WERE REVIEWED FOR COMPATIBILITY, AND IT WAS DETERMINED THAT THE FOLLOWING IMPLANTS ARE NOT COMPATIBLE: THE 00625006550 SCREW WITH THE TMARS CUP, AND THE AUGMENT, AND THE G7 LINER WITH THE TMARS CUP. MEDICAL RECORDS WERE NOT PROVIDED. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. THIS COMPLAINT CANNOT BE CONFIRMED. 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# 00489405810 LOT# 63392067 TRABECULAR METALÂ ACETABULAR REVISION SYSTEM ACETABULAR AUGMENT CAT# 00662406540; LOT# 64645209; BONE SCREW SELFTAPPING 40MM LENGTH 6.5MM DIA. CAT# 00-6624-065-50; LOT# 63704590; BONE SCR 6.5X50 SELF-TAP. CAT# 11-300814; LOT# 774180; ARCOS 14X150MM SPL TPR DIST. CAT# 11-300818; LOT# 147420; ARCOS 18X150MM SPL TPR DIST. CAT# 010000903; LOT# 3743858; G7 10 DEG E1 LINER 40MM F. CAT# 11-301331; LOT# 138850; ARCOS CON SZ A HI 70MM. CAT# 650-1058; LOT# 2993268; CER BIOLOXD OPTIONHD40MM. CAT# 650-1067; LOT# 3031106; CER OPTION TYPE 1 TPR SLEVE+3. CAT# 00700005620; LOT# 64564812; TRABECULAR METAL REVISION SHELL 56MM. PRODUCT REMAINS IMPLANTED WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 0001822565-2024-02532.

    Description of Event or Problem · 0

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

    Description of Event or Problem · 0

    IT WAS REPORTED THAT APPROXIMATELY 4 YEARS POST IMPLANTATION OF A RIGHT TOTAL HIP ARTHROPLASTY, THE PATIENT IS EXPERIENCING PAIN AND A LOOSE CUP. SUBSEQUENTLY, THE PATIENT IS BEING CONSIDERED FOR A REVISION ON AN UNKNOWN DATE. NO ADDITIONAL INFORMATION WAS AVAILABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2265885 BONE SCREW SELF-TAPPING 6.5 MM DIA. 50 MM LENGTH PROTHESIS, HIP LPH ZIMMER MANUFACTURING B.V. N/A 64561604 00889024119857

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Unknown Other