FDA Adverse Event Injury Summary report: N

36MM COCR MOD HD -3MM

MDR report key: 21737992 · Received April 1, 2025

Report

Report Number
0001825034-2025-00909
Event Type
Injury
Date Received
April 1, 2025
Date of Event
December 12, 2024
Report Date
July 7, 2025
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JDI
UDI-DI
00880304210516
PMA / PMN Number
K032396
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: 010000665 ITEM NAME G7 PPS LTD ACET SHELL 56F LOT # 3369449 010000856 ITEM NAME G7 NEUTRAL E1 LINER 36MM D LOT # 3302876 51-104160 ITEM NAME TPRLC 133 T1 PPS HO 16X152MM LOT # 324848 H6: COMPONENT CODE: HEAD 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

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED/CORRECTED UPDATED: D10: D10: 010000665, ITEM NAME: G7 PPS LTD ACET SHELL 56F, LOT # 3369449. 010000856, ITEM NAME: G7 NEUTRAL E1 LINER 36MM D, LOT # 3302876. 51-104160, ITEM NAME: TPRLC 133 T1 PPS HO 16X152MM, LOT # 3242848. 010000998, ITEM NAME: G7 ACETABULAR SCREW, LOT # 3287626.

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: B4;D4;G3;H2;H3;H4;H6;H10 IT HAS BEEN DETERMINED THAT THE EVENT IS NOT RELATED TO THE DEVICE. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. THE REPORTED PRODUCTS WERE REVIEWED FOR COMPATIBILITY WITH NO ISSUES NOTED. REPORTED EVENT IS NOT RELATED TO THE DEVICE THEREFORE, A COMPATIBILITY REVIEW IS NOT APPLICABLE. MEDICAL RECORDS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING: LEFT LATERAL HIP PAIN AND SYMPTOMS CONSISTENT WITH TROCHANTERIC BURSITIS. NO FURTHER ACTIONS WILL BE INITIATED AS A RESULT OF REPORTED EVENT. ROOT CAUSE OF THE REPORTED EVENT IS NOT DEVICE RELATED. BURSITIS IS THE INFLAMMATION OR IRRITATION OF THE BURSAE (THE FLUID FILLED SAC THAT CUSHIONS THE JOINT) AND IS TYPICALLY CAUSED BY REPETITIVE MOTION, OVERUSE, AND PRESSURE TO THE BURSAE. BURSITIS IS A VERY COMMON CONDITION THAT CAN IMPACT ANY OF THE JOINTS AND CAN LAST FOR A SHORT DURATION OR YEARS. SYMPTOMS THE PATIENT CAN EXPERIENCE INCLUDE PAIN, TENDERNESS, SWELLING, STIFFNESS, DECREASE IN MOVEMENT, AND/OR REDNESS AT OR AROUND THE JOINT THAT IS INVOLVED. CONSERVATIVE TREATMENT CONSISTS OF OVER THE COUNTER (OTC) MEDICATIONS PAIN RELIEVERS AND ANTI-INFLAMMATORIES, REST, ICE, ELEVATION, AND APPLYING PRESSURE WRAPS. IF CONSERVATIVE TREATMENTS FAIL, PHYSICAL THERAPY, ASPIRATION, ARTHROSCOPY, OR STEROID INJECTIONS MAY BE NECESSARY. THE COMPLAINT INDICATES THAT POSTOP BURSITIS DEVELOPED AND REQUIRED MEDICAL INTERVENTION FOR TREATMENT. 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 10 YEARS POST IMPLANTATION, THE PATIENT EXPERIENCED LEFT LATERAL PAIN CONSISTENT WITH TROCHANTER BURSITIS. PATIENT TOOK OVER THE COUNTER MEDICATION (NSAIDS) AND OUTPATIENT THERAPY WERE ADMINISTERED AND THE IMPLANTS REMAIN IMPLANTED. THERE IS NO FURTHER INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Description of Event or Problem · 0

THERE IS NO UPDATE TO THE PRIOR EVENT DESCRIPTION PROVIDED.

Description of Event or Problem · 0

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1171074 36MM COCR MOD HD -3MM PROSTHESIS, HIP JDI ZIMMER BIOMET, INC. 160920 00880304210516

Patients

Seq Age Sex Outcome Treatment
1 NA Male Other PLEASE SEE H11.| PLEASE SEE H11.