FDA Adverse Event Injury Summary report: N

REGENEREX RINGLOC 60MM MULTI HOLE ACETABULAR CUP SIZE 25

MDR report key: 6407810 · Received March 15, 2017

Report

Report Number
0001825034-2017-01639
Event Type
Injury
Date Received
March 15, 2017
Date of Event
November 4, 2016
Report Date
June 9, 2017
Manufacturer
BIOMET ORTHOPEDICS
Product Code
LPH
PMA / PMN Number
PK070369
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: MALLORY/HEAD FEMORAL STEM CATALOG#: 11-104212 LOT#: 213430, RINGLOC ACETABULAR LINER CATALOG#: EP-105995 LOT#: 404750, FEMORAL HEAD CATALOG#: 11-363662 LOT#: 049900, LOW PROFILE SCREW CATALOG#: 103535 LOT#: 380580 AND 642070, LOW PROFILE SCREW CATALOG#: 103532 LOT#: 420480. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS IT REMAINS IMPLANTED. DHR WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. THIS REPORT IS NUMBER 4 OF 4 MDRS FILED FOR THE SAME EVENT (REFERENCE 1825034-2017-01618, 01619, 01621, 01639).

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. DEVICE WAS NOT RETURNED SO NO PRODUCT EVALUATION COULD BE CONDUCTED. THIS DEVICE WAS USED FOR TREATMENT. DHR WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. REVIEW OF THE COMPLAINT HISTORY DETERMINED THAT NO FURTHER ACTION IS REQUIRED AS NO WERE TRENDS IDENTIFIED. ROOT CAUSE WAS UNABLE TO BE DETERMINED. 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 · 1

IT WAS REPORTED IN MEDICAL NOTES RECEIVED THAT PATIENT UNDERWENT A PROCEDURE APPROXIMATELY 12 MONTHS POST-IMPLANTATION DUE TO PAIN. THE PATIENT HAD A TEMPORARY STIMULATOR IMPLANTED, AND ONE MONTH LATER RECEIVED A PERMANENT STIMULATOR. NO ADDITIONAL PATIENT CONSEQUENCES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
190075 REGENEREX RINGLOC 60MM MULTI HOLE ACETABULAR CUP SIZE 25 PROSTHESIS, HIP LPH BIOMET ORTHOPEDICS N/A 376870

Patients

Seq Age Sex Outcome Treatment
1 69 YR Hospitalization| R