FDA Adverse Event Injury Summary report: N

M2A MAGNUM SYSTEM

MDR report key: 6506411 · Received April 19, 2017

Report

Report Number
0001825034-2017-02679
Event Type
Injury
Date Received
April 19, 2017
Date of Event
March 21, 2017
Report Date
September 30, 2017
Manufacturer
BIOMET ORTHOPEDICS
Product Code
KWA
PMA / PMN Number
PK042037
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: 157442 872650 M2A-MAGNUM MOD HD SZ 42MM; 139252 871340 M2A MAGNUM TPR ADPR TI DIA42-5 0/-6MMT1. 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. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034 - 2017 - 02680.

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 1

THE ADDITIONAL INFORMATION CONTAINED WITHIN THIS REPORT HAVE NO EFFECT ON PREVIOUS INVESTIGATION CONCLUSIONS. 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.

Additional Manufacturer Narrative · 1

THIS FOLLOW UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE INFORMATION CONTAINED WITHIN THIS REPORT DOES NOT ALTER PREVIOUS INVESTIGATION CONCLUSIONS. 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.

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT WAS REVISED APPROXIMATELY 8 YEARS¿ POST- IMPLANTATION DUE PATIENT EXPERIENCING PAIN. THE CUP AND HEAD WERE REMOVED. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE.

Description of Event or Problem · 1

IT WAS REPORTED PATIENT¿S LEFT HIP WAS REVISED APPROXIMATELY 8 YEARS-POST IMPLANTATION DUE TO PAIN. OPERATIVE REPORT STATED PATIENT FAILED CONSERVATIVE TREATMENT INCLUDING NSAIDS AND INJECTIONS. PATIENT WAS THEN REVISED FOR PAIN. THE ACETABULAR AND FEMORAL COMPONENTS WERE ASSESSED FOR LOOSENING AND PRESENCE OF OSTEOLYSIS. NO OSTEOLYSIS WAS NOTED THEREFORE, THE STEM WAS LEFT IN PLACE AND THE ACETABULUM WAS REMOVED. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
285646 M2A MAGNUM SYSTEM PROSTHESIS, HIP KWA BIOMET ORTHOPEDICS N/A 497230

Patients

Seq Age Sex Outcome Treatment
1 67 YR Hospitalization| R