FDA Adverse Event Injury Summary report: N

CER BIOLOXD OPTION HD 36MM

MDR report key: 20545048 · Received October 28, 2024

Report

Report Number
3002806535-2024-00409
Event Type
Injury
Date Received
October 28, 2024
Date of Event
October 2, 2024
Report Date
November 7, 2024
Manufacturer
BIOMET UK LTD.
Product Code
LZO
UDI-DI
00887868271397
PMA / PMN Number
K192683
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WI, 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. A REVIEW OF THE DEVICE MANUFACTURING RECORDS CONFIRMED NO ABNORMALITIES OR DEVIATIONS THAT COULD BE RELATED TO THE REPORTED EVENT. REVIEW OF THE COMPLAINT HISTORIES IDENTIFIED ADDITIONAL SIMILAR COMPLAINTS FOR THE REPORTED ITEMS AND NO ADDITIONAL SIMILAR COMPLAINTS FOR THE REPORTED PART AND LOT COMBINATIONS. COMPLAINTS ARE MONITORED PER COMPLAINT TRENDING PROCESS. BASED ON THE AVAILABLE INFORMATION, THE REPORTED EVENT CANNOT BE CONFIRMED. A DEFINITIVE ROOT CAUSE COULD NOT BE DETERMINED. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL REPORT WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Additional Manufacturer Narrative · 0

(B)(4): D10: ITEM # 650-1068, CER OPTION TYPE 1 TPR SLEVE +6, LOT # 3137180. ITEM # XL-156233, ARCOMXL 36MM RLC LNR +5MM SZ23, LOT # 65781860. ITEM # UNKNOW, UNKNOWN RINGLOC SHELL. LOT # UNKNOWN. ITEM # 00-7053-058-20, FULL BLADEG 58MM, LOT # UNKNOWN. 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.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION AT THIS TIME.

Description of Event or Problem · 0

IT WAS REPORTED PATIENT UNDERWENT HIP REVISION FOR UNKNOWN REASONS; THE SURGEON EXPLANTED FEMORAL HEAD AND ACETABULAR COMPONENTS. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1725712 CER BIOLOXD OPTION HD 36MM PROSTHESIS, HIP LZO BIOMET UK LTD. N/A 3062925 00887868271397

Patients

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