FDA Adverse Event Injury Summary report: N

NEXGEN STEM EXTENSION STRAIGHT

MDR report key: 2932190 · Received January 25, 2013

Report

Report Number
2648920-2013-00035
Event Type
Injury
Date Received
January 25, 2013
Report Date
December 29, 2012
Manufacturer
ZIMMER MANUFACTURING B.V.
Product Code
NJL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

AN X-RAY IMAGE WAS PROVIDED FROM POST-OP; IT DOES NOT APPEAR THAT THERE ARE ANY SIGNIFICANT ISSUES WITH THE DEVICES, WITH REGARD TO COMPONENT POSITION, ETC. ADDITIONALLY, IT IS NOT APPARENT IF THE SET SCREWS HAVE MIGRATED OUT OF THE MORSE TAPER/STEM CONNECTION AREA IN THE (B)(4) SURGICAL TECHNIQUE, IT STATES TO STRIKE THE STEM EXTENSION ONLY ONCE TO SEAT THE TAPER; STRIKING TWICE MAY LOOSEN THE LOCKING MECHANISM. ADDITIONALLY, IT IS RECOMMENDED TO TORQUE BOTH SET SCREWS BY HAND TO ENSURE THE STEM IS LOCKED ON TIGHTLY. AS NO OPERATIVE NOTES WERE SUPPLIED, IT IS UNK IF SURGICAL TECHNIQUE WAS A FACTOR. WITHOUT SUFFICIENT EVIDENCE, ROOT CAUSE CANNOT BE DETERMINED AT THIS TIME. REVIEW OF THE DEVICE HISTORY RECORDS DID NOT FIND ANY DEVIATIONS OR ANOMALIES. IT IS NOT SUSPECTED THAT THE PRODUCT FAILED TO MEET SPECIFICATIONS. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT CONTRIBUTION TO THE REPORTED PROBLEM. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. SHOULD ADD¿L SUBSTANTIVE INFO BE RECEIVED, THE COMPLAINT WILL BE REOPENED. ZIMMER, INC. CONSIDERS THE INVESTIGATION CLOSED.

Description of Event or Problem · 1

IT IS REPORTED AN (B)(4) STEM WAS IMPACTED AND SECURED WITH A SCREW. POST-OP X-RAYS DONE 2 DAYS LATER REVEALED THAT THE STEM WAS LOOSE AND HAD MIGRATED IN THE FEMORAL CANAL. REVISION SURGERY IS PLANNED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
36104 NEXGEN STEM EXTENSION STRAIGHT NJL ZIMMER MANUFACTURING B.V. 61675771

Patients

Seq Age Sex Outcome Treatment
1 57 YR Other