FDA Adverse Event Injury Summary report: N

ANN PH NAIL RT 10X220MM

MDR report key: 23074147 · Received September 17, 2025

Report

Report Number
0009613350-2025-00708
Event Type
Injury
Date Received
September 17, 2025
Date of Event
August 22, 2025
Report Date
September 17, 2025
Manufacturer
ZIMMER GMBH
Product Code
HSB
UDI-DI
00889024505919
PMA / PMN Number
K200814
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10. ANN BLUNT TIP SCREW 4X50MM ITEM# 47248605040 LOT# 3228024. ANN BLUNT TIP SCREW 4X50MM ITEM# 47248605040 LOT# 3228198. ANN BLUNT TIP SCREW 4X52MM ITEM# 47248605240 LOT# 3076792. BLUNT TIP SCREW, ÿ 4X52MM ITEM# 47248605240 LOT# 3207865. BLUNT TIP SCREW, ÿ 4X54MM ITEM# 47248605440 LOT# 3157875. CORTICAL BONE SCREW, ÿ 4X28MM ITEM# 47248612840 LOT# 3240162. CORTICAL BONE SCREW, ÿ 4X30MM ITEM# 47248613040 LOT# 3225546. PROXIMAL HUMERUS NAIL CAP, 0MM ITEM# 47248801000 LOT# 3242939. G2. REPORT SOURCE: JAPAN. NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; A PRODUCT EVALUATION COULD NOT BE PERFORMED. A REVIEW OF THE DEVICE MANUFACTURING RECORDS CONFIRMED NO ABNORMALITIES OR DEVIATIONS. REVIEW OF THE COMPLAINT HISTORIES IDENTIFIED ADDITIONAL SIMILAR COMPLAINTS FOR THE REPORTED ITEMS AND THE PART AND LOT COMBINATIONS. COMPLAINTS ARE MONITORED PER COMPLAINT TRENDING PROCESS IN ORDER TO IDENTIFY POTENTIAL ADVERSE TRENDS. RADIOGRAPHS WERE PROVIDED AND REVIEWED BY A RADIOLOGIST. THE REVIEW IDENTIFIED THE FOLLOWING: PHOTO OF A COMPUTER SCREEN SHOWING A FLUOROSCOPIC AP IMAGE OF THE PROXIMAL HUMERUS WITH FIVE INTERLOCKING SCREWS. INTRAMEDULLARY NAIL IN THE HUMERUS SPANNING WHAT APPEARS TO BE A PROXIMAL HUMERAL METADIAPHYSIS FRACTURE. THREE OF THE SCREW HEADS ARE PROUD WITH SUBSTANTIAL BACKOUT OF THE PROXIMAL SCREW. AS THE DEVICES INVOLVED IN THE REPORTED EVENT WERE NOT RETURNED FOR INVESTIGATION, A FURTHER PRODUCT EVALUATION COULD NOT BE PERFORMED AND THE CONDITION OF THE PRODUCTS ARE UNKNOWN. IT CAN BE ASSUMED THAT MULTIPLE CONTRIBUTING FACTORS, RELATED TO EITHER PATIENT CONDITION AND BEHAVIOR OR IMPLANTATION PROCEDURE, CONTRIBUTED TO THE MIGRATION OF THE SCREWS. IF AND TO WHAT EXTENT ANY OF THESE ASPECTS MAY HAVE INFLUENCED THE MIGRATION OF THE SCREW REMAINS UNKNOWN. IN CONCLUSION, AS THE CAUSE MAY BE MULTIFACTORIAL, AN EXACT ROOT CAUSE COULD NOT BE IDENTIFIED FOR THE MIGRATION OF THE SCREW. 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 OPERATION WAS PERFORMED WITH ANN NAIL. ONE WEEK AFTER THE INITIAL SURGERY, SURGEON FOUND ONE OF THE PROXIMAL SCREWS WAS BACKED OUT FROM THE PROPER POSITION. TWO WEEKS AFTER THE INITIAL SURGERY, ALL OF THE PROXIMAL SCREWS WERE BACKED OUT FROM THE PROPER POSITION AND SUBSEQUENTLY UNDERWENT A REVISION SURGERY, DURING WHICH, THE SURGEON CONFIRMED THAT THE CORELOCK HAD BECOME LOOSE. THEN THE SCREW DEPTH WAS READJUSTED, THE CORELOCK WAS RETIGHTENED, AND THE REVISION WAS COMPLETED. DILIGENCE IS COMPLETED AND NO FURTHER INFORMATION ON THE REPORTED EVENT HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1636397 ANN PH NAIL RT 10X220MM IMPLANT, TRAUMA HSB ZIMMER GMBH 3174907 00889024505919

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Hospitalization| R