FDA Adverse Event Injury Summary report: N

TRILOGY STANDARD LINER

MDR report key: 3122190 · Received May 17, 2013

Report

Report Number
1822565-2013-00822
Event Type
Injury
Date Received
May 17, 2013
Date of Event
April 11, 2013
Report Date
April 18, 2013
Manufacturer
ZIMMER, INC.
Product Code
LPH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: THE ZIMMER STERILIZATION VENDOR PROCESSES ALL IMPLANTS TO MEET FDA REGULATIONS AND ISO STANDARDS AT A STERILITY ASSURANCE LEVEL (SAL) OF 1.0 X 10-6 OR BETTER. THEREFORE, IT IS HIGHLY UNLIKELY THAT THE SPECIFIED DEVICE CAUSED OR CONTRIBUTED TO ANY PT INFECTION. THE RETURNED ASSEMBLY WAS LOCKED TOGETHER AS THE LOCKING RING WAS DAMAGED SUCH THAT THE LINER AND SHELL ARE LOCKED TOGETHER. THE LINER HAD SOME DISCOLORATION FROM BEING IN VIVO. THE LINER HAS DAMAGE TO THE RIM FROM ATTEMPTS TO BE REMOVED FROM THE LINER. DEVICE HISTORY RECORDS INDICATE ALL COMPONENTS WERE MANUFACTURED AND INSPECTED TO SPECIFICATION.

Description of Event or Problem · 1

IT IS REPORTED THAT THE PT WAS REVISED DUE TO INFECTION. THE SURGEON MENTIONED THE LINER LOOKED A BIT DULL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
218805 TRILOGY STANDARD LINER LPH ZIMMER, INC. 60018108

Patients

Seq Age Sex Outcome Treatment
1 75 YR Required Intervention MANUFACTURED BY ZIMMER (B)(4)| TRILOGY SHELL WITH CLUSTER HOLES:| CATALOG #00620005222, LOT #60023049