FDA Adverse Event Injury Summary report: N

ECHO BI-METRIC HIP SYSTEM

MDR report key: 21717878 · Received March 28, 2025

Report

Report Number
0001822565-2025-00800
Event Type
Injury
Date Received
March 28, 2025
Report Date
April 10, 2025
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWA
PMA / PMN Number
K070274
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10: CAT: 12-115111 LOT: 2965002 CER BIOLOXD MOD HD 28MM +3 NK CAT: 110010268 LOT: 6463667 G7 OSSEOTI MULTIHOLE 60MM G CAT: 110024465 LOT: 665360 G7 DUAL MOBILITY LINER 46MM G H6: PROPOSED COMPONENT COODE: SUGGESTED COMPONENT CODE: MECHANICAL (G04) - STEM THE CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS ITS LOCATION IS UNKNOWN. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

UPON RECEIVING ADDITIONAL INFORMATION OF THE REPORTED EVENT, IT WAS DETERMINED TO BE NOT REPORTABLE AS THIS PRODUCT WAS NOT INVOLVED IN THE EVENT. THE INITIAL REPORT SHOULD BE VOIDED.

Description of Event or Problem · 0

IT WAS REPORTED THAT APPROXIMATELY FIVE YEARS POST-IMPLANTATION, THE PATIENT WILL BE REVISED DUE TO UNKNOWN REASONS. IT IS UNKNOWN IF A REVISION HAS TAKEN PLACE. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Description of Event or Problem · 0

UPON RECEIVING ADDITIONAL INFORMATION OF THE REPORTED EVENT, IT WAS DETERMINED TO BE NOT REPORTABLE AS THIS PRODUCT WAS NOT INVOLVED IN THE EVENT. THE INITIAL REPORT SHOULD BE VOIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1437940 ECHO BI-METRIC HIP SYSTEM PROSTHESIS, HIP KWA ZIMMER BIOMET, INC. 441380

Patients

Seq Age Sex Outcome Treatment
1 NA Male Other SEE H11 NARRATIVE