FDA Adverse Event Injury Summary report: N

RINGLOC-X ARCOM LINER

MDR report key: 6728966 · Received July 20, 2017

Report

Report Number
3002806535-2017-00606
Event Type
Injury
Date Received
July 20, 2017
Date of Event
March 29, 2017
Report Date
July 20, 2017
Manufacturer
BIOMET UK LTD.
Product Code
LPH
PMA / PMN Number
PSEE H10
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
DA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). DATE OF BIRTH - UNKNOWN DATE IN (B)(6). REPORT SOURCE, FOREIGN ¿ EVENT OCCURRED IN (B)(6). THIS PRODUCT IS MANUFACTURED BY ZIMMER BIOMET (B)(4) AND IS NOT CLEARED OR DISTRIBUTED IN THE U.S. HOWEVER, THIS REPORT IS BEING SUBMITTED AS ZIMMER BIOMET (B)(4) MANUFACTURES A SIMILAR DEVICE THAT IS CLEARED OR DISTRIBUTED IN THE UNITED STATES UNDER 510(K) NUMBER K023357. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORT: 3002806535-2017-00605.

Description of Event or Problem · 1

IT WAS REPORTED A PATIENT EXPERIENCED SWELLING, PAIN, AND ERYSIPELAS AFTER A TOTAL HIP ARTHROPLASTY. THE PATIENT WAS TREATED WITH MEDICATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
509626 RINGLOC-X ARCOM LINER PROSTHESIS, HIP LPH BIOMET UK LTD. N/A 3858818

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention COCR MODULAR HEAD| EXCEED ABT RINGLOC-X SHELL| SIRIUS HIP STEM