FDA Adverse Event Injury Summary report: N

ARCOS MODULAR REVISION HIP SYSTEM

MDR report key: 23003857 · Received September 9, 2025

Report

Report Number
0001825034-2025-02836
Event Type
Injury
Date Received
September 9, 2025
Date of Event
September 5, 2025
Report Date
January 21, 2026
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWA
UDI-DI
00880304474208
PMA / PMN Number
K090757
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: B5; B7; D6; G3; H2; H6 CLINICAL. THE FOLLOWING SECTIONS WERE CORRECTED: H6 IMPACT. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

(B)(4). D10: CAT: 11-301816 LOT: 128460 ARCOS 16X200MM INTLKNG DIST. CAT: 166067 LOT: 6130827 ARCOS DISTAL SCREW TI 5X35MM. G2: FOREIGN ¿ THE NETHERLANDS. H6: 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

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: G3; H2; H3; H6; H10. THE FOLLOWING SECTIONS WERE CORRECTED: B3; H4. VISUAL EXAMINATION OF THE RETURNED PRODUCT IDENTIFIED THE BOLT VISUALLY APPEARS TO BE IN GOOD COSMETIC CONDITION, THERE ARE MINOR SCRATCHES AROUND THE MID SHAFT DIAMETER. NO OTHER DAMAGE WAS NOTED DURING VISUAL EVALUATION. THE DIMENSIONS OF THE LENGTH OF THE BOLT AND TIP LENGTH WERE MEASURED AND FOUND TO BE WITHIN SPECIFICATION. THIS DEVICE HAS AN APPROXIMATE IMPLANTATION AGE OF 6 YEARS. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING. MEDICAL RECORDS/RADIOGRAPHS WERE PROVIDED. REVIEW IDENTIFIED THE FOLLOWING: PATIENT HAD AN INITIAL LEFT THA WITH UNKNOWN PRODUCTS. PATIENT UNDERWENT A TWO STAGE REVISION DUE TO INFECTION. DURING THE STAGE 2 PROCEDURE, A TROCHANTERIC MINOR AND MAJOR WERE FOUND FRACTURED AND NEW ARCOS IMPLANTS WERE PLACED ALONG WITH ARCOS CLAW, BOLT AND NEW CERCLAGE WIRES. OPERATIVE NOTES INDICATE THERE IS GOOD STABILITY AND FUNCTION. THE PATIENT HAD AN ADDITIONAL PROCEDURE DUE TO THE TROCHANTERIC BOLT BACKING OUT OF THE SCREW HOLE. THE BOLT AND CLAW WERE REMOVED. NO OPERATIVE RECORDS WERE PROVIDED FOR THIS PROCEDURE. AN X-RAY IMAGE WAS PROVIDED, HOWEVER WAS NOT FURTHER REVIEWED AS THE IMAGE DOES NOT PROVIDE A CLEAR VIEW OF THE BOLT. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. COMPLAINT IS NOT CONFIRMED. 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 APPROXIMATELY SIX YEARS POST-IMPLANTATION, THE PATIENT UNDERWENT A LEFT HIP PROCEDURE DUE TO THE TROCHANTERIC BOLT BACKING OUT OF THE SCREW HOLE THAT IS USED TO SECURE THE TROCHANTERIC CLAW TO THE PROXIMAL BODY AND PAIN. THE BOLT AND CLAW WERE REMOVED AND NOT REPLACED. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT A HIP REVISION DUE TO THE TROCHANTERIC BOLT BACKING OUT OF THE SCREW HOLE THAT IS USED TO SECURE THE TROCHANTERIC CLAW TO THE PROXIMAL BODY. IT HAS NOT BEEN CONFIRMED WHICH COMPONENTS WERE REVISED, BUT A SCREW WAS REMOVED. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Description of Event or Problem · 0

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
386883 ARCOS MODULAR REVISION HIP SYSTEM PROSTHESIS, HIP KWA ZIMMER BIOMET, INC. 931680 00880304474208

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention| H