FDA Adverse Event Injury Summary report: N

UNKNOWN AVANTAGE HEAD

MDR report key: 21534260 · Received March 6, 2025

Report

Report Number
3002806535-2025-00105
Event Type
Injury
Date Received
March 6, 2025
Date of Event
February 17, 2025
Report Date
March 25, 2025
Manufacturer
BIOMET UK LTD.
Product Code
LZO
PMA / PMN Number
EXEMPT
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D4: THIS DEVICE IS SOLD OUTSIDE THE US, AND THEREFORE NO GUDID INFORMATION EXISTS. THIS DEVICE IS CONSIDERED SIMILAR TO (B)(4). D10: AVAN E1 INSERT 28 S 52; ITEM: P0561E52; LOT: 0001842725. G2¿FOREIGN¿AUSTRALIA. G4: THE REPORTED PRODUCT IS NOT SOLD IN THE US; THE PRE-MARKET SUBMISSION NUMBER FOR THE SIMILAR PRODUCT SOLD IN THE US IS K082996. 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.

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL AND/OR CORRECTED INFORMATION. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; A PRODUCT EVALUATION COULD NOT BE PERFORMED. A REVIEW OF THE DEVICE MANUFACTURING RECORDS COULD NOT BE PERFORMED DUE TO A MISSING LOT NUMBER. A REVIEW OF THE COMPLAINT HISTORY COULD NOT BE PERFORMED DUE TO MISSING REFERENCE AND LOT NUMBERS. A DEFINITIVE ROOT CAUSE CANNOT BE ESTABLISHED. 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.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT HIP REVISION SURGERY DUE TO DISLOCATION APPROXIMATELY 2 DAYS POST-IMPLANTATION. THE LINER AND HEAD WERE CHANGED. ATTEMPTS HAVE BEEN MADE AND ALL ADDITIONAL INFORMATION RECEIVED HAS BEEN INCLUDED IN THIS REPORT.

Description of Event or Problem · 0

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
486158 UNKNOWN AVANTAGE HEAD HIP PROSTHESIS LZO BIOMET UK LTD. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 42 YR Female Hospitalization| R SEE H10 NARRATIVE