M2A-MAGNUM MOD HD SZ 44MM
Report
- Report Number
- 0001825034-2026-01173
- Event Type
- Injury
- Date Received
- April 30, 2026
- Date of Event
- May 11, 2022
- Report Date
- April 30, 2026
- Manufacturer
- ZIMMER BIOMET, INC.
- Product Code
- LPH
- PMA / PMN Number
- K101336
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
(B)(4). D10: BIOMET PART NUMBER 11-104108 MLRY-HD POR FMRL 8X145MM LOT NUMBER 128190. BIOMET PART NUMBER 139252 M2A-MAGNUM 42-50MM TPR INSRT-6 LOT NUMBER 902500. G2: FOREIGN - EVENT OCCURRED IN CANADA. H6: PROPOSED COMPONENT CODE : MECHANICAL (G04) - HEAD. 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.
IT WAS REPORTED A PATIENT WITH HIP DYSPLASIA UNDERWENT AN INITIAL LEFT TOTAL HIP ARTHROPLASTY. SUBSEQUENTLY, PATIENT DEVELOPED PAIN AND UNDERWENT A REVISION APPROXIMATELY 15 YEARS POST-IMPLANTATION. DURING THE PROCEDURE, ENCOUNTERED TROCHANTERIC BURSITIS, BEAD DISASSOCIATION FROM THE CUP WITH CUP DISLODGEMENT AND EROSION THROUGH THE ANTERIOR COLUMN, METAL STAINED TISSUES, AND A PSEUDO CAPSULE. THE CUP, HEAD, AND TAPER WERE ALL REVISED WITHOUT COMPLICATION. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 62298 | M2A-MAGNUM MOD HD SZ 44MM | PROSTHESIS, HIP | LPH | ZIMMER BIOMET, INC. | 871730 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 50 YR | Unknown | Hospitalization| R |