FDA Adverse Event Injury Summary report: N

UNKNOWN HARRIS/GALANTE FEMORAL COMPONENT

MDR report key: 5472406 · Received March 1, 2016

Report

Report Number
1822565-2016-00525
Event Type
Injury
Date Received
March 1, 2016
Report Date
February 2, 2016
Manufacturer
ZIMMER INC
Product Code
KWZ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

INFORMATION WAS RECEIVED VIA PUBLISHED LITERATURE. EVENT PROBLEM CODES: (B)(4). REFERENCE THE LITERATURE AT THE FOLLOWING ADDRESS: HTTP://WWW.NCBI.NLM.NIH.GOV/PUBMED/3183679. THIS REPORT WILL BE AMENDED WHEN OUR INVESTIGATION IS COMPLETE.

Additional Manufacturer Narrative · 1

NO DEVICE OR PHOTOS WERE RECEIVED; THEREFORE THE CONDITION OF THE COMPONENT IS UNKNOWN. DEVICE HISTORY RECORDS CANNOT BE REVIEWED SINCE THE PART AND LOT NUMBERS ARE UNKNOWN. THESE DEVICES ARE USED FOR TREATMENT. SURGICAL NOTES WERE NOT PROVIDED; IT IS UNKNOWN WHETHER THE COMPONENTS WERE IMPLANTED WITH THE CORRECT FIT AND ORIENTATION AS PER THE SURGICAL TECHNIQUE. IN THE JOURNAL ARTICLE, IT WAS NOTED THAT THE STEMS SHOWED VERY LIMITED BONE INGROWTH, IN SPITE OF GOOD SURGICAL FIT, ABSENCE OF SCLEROTIC LINES, SUBSIDENCE, OR SIGNS OF SIGNIFICANT STRESS SHIELDING. PRODUCT HISTORY SEARCH CANNOT BE COMPLETED SINCE THE PART AND LOT NUMBER IS UNKNOWN. RELEVANT MEDICAL HISTORY AND ADHERENCE TO THE REHABILITATION PROTOCOL ARE UNKNOWN. A DEFINITE ROOT CAUSE CANNOT BE DETERMINED WITH THE INFORMATION PROVIDED.

Description of Event or Problem · 1

IT IS REPORTED THAT THREE PATIENTS' FEMORAL STEMS WERE REVISED DUE TO AN UNKNOWN REASON.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
126566 UNKNOWN HARRIS/GALANTE FEMORAL COMPONENT HIP PROSTHESIS KWZ ZIMMER INC

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention