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 |