FDA Adverse Event Injury Summary report: N

G7 BONEMASTER LTD ACET SHL 48C

MDR report key: 22299522 · Received June 20, 2025

Report

Report Number
0001825034-2025-01809
Event Type
Injury
Date Received
June 20, 2025
Date of Event
February 27, 2025
Report Date
June 18, 2025
Manufacturer
ZIMMER BIOMET, INC.
Product Code
PBI
UDI-DI
00880304524606
PMA / PMN Number
K121874
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). D10: 163667 32MM MOD HEAD COCR -6MM NECK 65875036, 010000925 G7 HI-WALL E1 LINER 32MM C 7240687, 51-117090 TPRLC 133 MP TYPE1 BM HO 9.0 7563993. G2: FOREIGN: AUSTRALIA. VISUAL EXAMINATION OF THE PROVIDED PICTURES IDENTIFIED THE EXPLANTED STEM AND HEAD, COVERED WITH BIO DEBRIS. THE STEM COMPONENT IS SEEN WITH LARGE TISSUE MASS ON THE POROUS COATING, WITH SOME AREAS OF THE POROUS COATING WITH DAMAGE. NO OTHER OBSERVATIONS CAN BE MADE FOR THE STEM AND HEAD USING THE IMAGE ALONE. NO PRODUCT WAS RETURNED; FURTHER VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING. REVIEW OF COMPLAINT HISTORY FOUND NO ADDITIONAL RELATED ISSUES FOR THIS ITEM AND THE REPORTED PART AND LOT COMBINATION. RADIOGRAPHS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING: TWO VIEWS OF THE RIGHT HIP DEMONSTRATE A RIGHT TOTAL HIP ARTHROPLASTY WITH SCREW FIXATION OF THE ACETABULAR CUP. MILD RADIOLUCENCY OF THE CEMENT HARDWARE INTERFACE. FEMORAL COMPONENT ALSO DEMONSTRATES MILD RADIOLUCENCY OF THE CEMENT HARDWARE INTERFACE. RIGHT TOTAL HIP ARTHROPLASTY WITH POSSIBLE EVIDENCE OF EARLY LOOSENING OF THE ACETABULAR AND FEMORAL COMPONENTS. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. BASED ON THE PROVIDED IMAGE AND MMI, THE COMPLAINT IS CONFIRMED. 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 AN INITIAL PROCEDURE. THE PATIENT DID WELL FOR THE FIRST FEW MONTH¿S POST OPERATIONS, HOWEVER, THE PATIENT RECENTLY SUFFERED RECURRENT DISLOCATIONS. NO TRAUMATIC EVENT PROCEEDED OR RESULTED FROM ANY OF THESE DISLOCATIONS. A CT WAS ORDERED, AND THE FEMORAL STEM WAS DEEMED TO BE IN AN INSUFFICIENT DEGREE OF ANTEVERSION. THE STEM WAS CHANGED TO A MODULAR ARCOS TO CORRECT THE ANTEVERSION AND THE HIGH WALL LINER WAS EXCHANGED FOR A DUAL MOBILITY. THE G7 IN SITU WAS RETAINED. NO SIGNS OF INFECTION. NO FRACTURES PRESENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2200894 G7 BONEMASTER LTD ACET SHL 48C PROSTHESIS, HIPS PBI ZIMMER BIOMET, INC. N/A 7569976 00880304524606

Patients

Seq Age Sex Outcome Treatment
1 56 YR Female Hospitalization| R