FDA Adverse Event Injury Summary report: N

RINCLOC AND QUICK CONNECT DRILL BIT

MDR report key: 6739188 · Received July 24, 2017

Report

Report Number
0001825034-2017-05184
Event Type
Injury
Date Received
July 24, 2017
Report Date
July 24, 2017
Manufacturer
BIOMET ORTHOPEDICS
Product Code
HTW
PMA / PMN Number
PEXEMPT
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
PATIENT FAMILY MEMBER OR FRIEND

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, (STILL IMPLANTED). THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. CONCOMITANT PRODUCTS: STAINLESS STEEL CABLE/SLEEVE COMBO P/N 350806 L/N 790570; MODULAR HEAD COMPONENT P/N 163670 L/N 561090; RING LOC ACETABULAR LINER P/N 11-105924 L/N 097620; COLLARLESS BI-METRIC POROUS STEM P/N X11-180313 L/N 340400; RINCLOC AND QUICK CONNECT DRILL BIT P/N 31-323230 L/N 016260; RANAWAT/BURSTEIN ACETABULAR SHELL P/N 11-106054 L/N 7751510; TI LOW PROFILE SCREW P/N 106537 L/N 016260. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT. PLEASE SEE REPORTS: 0001825034-2017-05179, 0001825034-2017-05180, 0001825034-2017-05181, 0001825034-2017-05183, 0001825034-2017-05184, 0001825034-2017-05185, 0001825034-2017-05182.

Additional Manufacturer Narrative · 1

UPON REASSESSMENT OF THE REPORTED EVENT, IT WAS DETERMINED TO NOT BE REPORTABLE AS THIS DEVICE WAS NOT INVOLVED IN THE EVENT. THE INITIAL REPORT WAS SUBMITTED IN ERROR AND SHOULD BE VOIDED.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT HAD AN INITIAL PROCEDURE NINE YEARS AGO AND EXPERIENCING PAIN THROUGH THE RIGHT LEG. PATIENT IS UNAWARE IF THE SURGERY WAS PERFORMED CORRECTLY WHEN INSTALLING THE HIP. ATTEMPTS TO OBTAIN ADDITIONAL INFORMATION HAVE BEEN MADE; HOWEVER, NO MORE IS AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
518794 RINCLOC AND QUICK CONNECT DRILL BIT PROSTHESIS, HIP HTW BIOMET ORTHOPEDICS N/A 016260

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization