FDA Adverse Event Injury Summary report: N

BIOLOX DELTA CER OPTION HD 36MM

MDR report key: 22493228 · Received July 14, 2025

Report

Report Number
3002806535-2025-00265
Event Type
Injury
Date Received
July 14, 2025
Date of Event
May 30, 2025
Report Date
November 6, 2025
Manufacturer
BIOMET UK LTD.
Product Code
LZO
UDI-DI
00880304521957
PMA / PMN Number
K200959
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WV, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10 - ASSOCIATED MEDICAL DEVICES: G7 NEU +5MM ARCOMXL LNR 36MM G; ITEM# 110017187; LOT# 6279288. G7 PPS LTD ACET SHELL 60G; ITEM# 010000667; LOT# 6278180. TPRLC 133 T1 PPS HO 18X156MM; ITEM# 51-104180; LOT# 6360476. CER OPTION TYPE 1 TPR SLEVE +6; ITEM# 650-1068; LOT# 2953805. 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 INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: B4, B5, G3, G6, H2, H3, H6, H11. VISUAL EXAMINATION OF THE PROVIDED PICTURES IDENTIFIED THE CERAMIC HEAD AND LINER IN A BAG. THE CERAMIC HEAD APPEARS TO CONTAIN A SIGNIFICANT AMOUNT MARKING VISUALLY CONSISTENT WITH METAL TRANSFER WHICH INDICATES THAT THE HEAD HAS BEEN IN CONTACT WITH METAL. 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. MEDICAL RECORDS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING: AN INITIAL LEFT THA WAS PERFORMED. THE PATIENT EXPERIENCED SUDDEN SQUEAKING IN THE HIP AFTER 6 YEARS. A REVISION WAS PERFORMED, WHERE A PSEUDOCAPSULE WAS DEBRIDED. A DARK WEAR STRIPE WAS NOTED TO THE CERAMIC HEAD AND THE POLYETHYLENE RING HAD SHEARED OFF THE POLY AND WAS STILL PRESENT IN THE LOCKING GROOVE OF THE ACETABULAR COMPONENT. THE HEAD AND LINER WERE EXPLANTED AND REPLACED. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. 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 BY LEGAL THAT A PATIENT HAD AN INITIAL LEFT TOTAL HIP ARTHROPLASTY. THE PATIENT HAD BEEN DOING WELL FOR 6 YEARS BUT PRESENTED WITH SUDDEN SQUEAKING IN THE HIP AFTER AN ACTIVE DAY. X-RAY AND CT SHOWED EVIDENCE OF A DISSOCIATED POLY INSERT. THE PATIENT RETURNED TO SURGERY 6 YEARS AND 2 MONTHS POST THE INITIAL OPERATION. DURING WHICH, A PSEUDOCAPSULE WAS DEBRIDED FROM THE JOINT WHICH REVEALED A DISLODGED POLY LINER AND A DARK STRIPE WEAR ON THE CERAMIC HEAD. THE HEAD WAS REMOVED FROM THE TAPER SLEEVE, BUT THE SLEEVE WAS COLD WELDED TO THE FEMORAL COMPONENT AND COULD NOT BE REMOVED. WHEN THE LINER WAS REMOVED FROM THE CUP, IT WAS IDENTIFIED THAT THE POLY LOCKING RING HAD SHEARED OFF THE POLY AND WAS STILL PRESENT IN THE LOCKING GROOVE OF THE ACETABULAR COMPONENT. THE INITIAL STEM AND CUP REMAINED INTACT. NO INTRA-OP COMPLICATIONS WERE IDENTIFIED. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED AT THE TIME OF THIS REPORT.

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
1046675 BIOLOX DELTA CER OPTION HD 36MM HIP PROSTHESIS LZO BIOMET UK LTD. 2960379 00880304521957

Patients

Seq Age Sex Outcome Treatment
1 NA Male Required Intervention| H SEE H11 NARRATIVE.