FDA Adverse Event Injury Summary report: N

G7 DUAL MOBILITY ACETABULAR SYSTEM

MDR report key: 21515827 · Received March 4, 2025

Report

Report Number
0001825034-2025-00544
Event Type
Injury
Date Received
March 4, 2025
Date of Event
January 28, 2025
Report Date
July 9, 2025
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LPH
UDI-DI
00880304703520
PMA / PMN Number
K150522
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AR, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10: (B)(6) ITEM NAME BEARING 28 MM I.D. 44 MM O.D. SIZE F LOT # 66882645; (B)(6) ITEM NAME BIOLOX® DELTA, CERAMIC FEMORAL HEAD, L, ø 28/+3.5, TAPER 12/14 LOT # 3201313. 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

Additional Manufacturer Narrative · 0

(B)(4) THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: D4; G3; E1; H2. THE FOLLOWING SECTIONS WERE CORRECTED: A2; B7; D1; D5; G2. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: G3; H2; H3; H4; H6 NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. REVIEW OF THE DEVICE HISTORY RECORD IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. MEDICAL RECORDS/RADIOGRAPHS WERE PROVIDED. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING: PATIENT HAD AN INITIAL RIGHT THA AND HAD A REVISION DUE TO A TWISTING INJURY CAUSING PAIN AND SUPERIOR DISLOCATION. STEM WAS STABLE. THE CUP WAS A LITTLE ANTEVERTED BUT NOT BAD, BUT IT WAS DECIDED TO REVISE THE CUP. A POST-REVISION X-RAY REPORTS GOOD POSITION AND ALIGNMENT WITH NO EVIDENCE OF FAILURE OR LOOSENING. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. BASED ON THE MEDICAL RECORDS, THE COMPLAINT IS 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT A REVISION PROCEDURE 26 DAYS POST IMPLANTATION DUE TO A TWISTING INJURY CAUSING PAIN AND DISLOCATION. THE STEM WAS RETAINED AND ALL OTHER IMPLANTS WERE REVISED WITHOUT COMPLICATION. THERE IS NO ADDITIONAL INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Description of Event or Problem · 0

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

Description of Event or Problem · 0

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
676830 G7 DUAL MOBILITY ACETABULAR SYSTEM PROSTHESIS, HIP LPH ZIMMER BIOMET, INC. 66624090 00880304703520

Patients

Seq Age Sex Outcome Treatment
1 63 YR Male Required Intervention| H PLEASE SEE H11