G7 ACETABULAR SYSTEM
Report
- Report Number
- 0001825034-2017-06914
- Event Type
- Injury
- Date Received
- September 6, 2017
- Date of Event
- October 25, 2017
- Report Date
- February 9, 2018
- Manufacturer
- BIOMET ORTHOPEDICS
- Product Code
- JDI
- PMA / PMN Number
- PK121874
- Removal / Correction Number
- N/A
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- OTHER
Narratives
THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. CONCOMITANT MEDICAL PRODUCTS: BIOLOX® OPTION, HEAD, XL,28/+7, TAPER 12/14 P/N 00877702804 L/N 2844958, TRABECULAR METAL ACETABULAR REVISION SYSTEM ACETABULAR AUGMENT P/N 00489405420 L/N 63271869. (B)(4). REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DHR WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. REVIEW OF THE COMPLAINT HISTORY DETERMINED THAT NO FURTHER ACTION IS REQUIRED. ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. THERE ARE WARNINGS IN THE PACKAGE INSERT THAT THIS TYPE OF EVENT CAN OCCUR AND RISKS ARE ADDRESSED IN THE ASSOCIATED RISK DOCUMENTATION. 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.
THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. 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.
CONCOMITANT PRODUCTS: PART: 110024464 NAME: G7 DUAL MOBILITY LINER 44MM F LOT: 924650, PART: EP-200150 NAME: ACT ARTIC E1 HIP BRG 28X44MM LOT: 802000, PART: 010000996 NAME: G7 SCREW 6.5MM X 15MM LOT: 3741173, PART: 010000996 NAME: G7 SCREW 6.5MM X 15MM LOT: 3805567, PART: 010000997 NAME: G7 SCREW 6.5MM X 20MM LOT: 3666651, PART: 010000997 NAME: G7 SCREW 6.5MM X 20MM LOT: 3974192, PART: 010001000 NAME: G7 SCREW 6.5MM X 35MM LOT: 3970984. THE DEVICE WAS NOT RETURNED FOR MANUFACTURER EVALUATION. ALTHOUGH A REVISION SURGERY HAS BEEN INDICATED, IT HAS NOT BEEN CONFIRMED THE PATIENT HAS BEEN REVISED AND THE DEVICES ARE ASSUMED YET IMPLANTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS COMPLAINT. PLEASE SEE ADDITIONAL REPORTS: 0001825034-2017-06908, 0001825034-2017-06909, 0001825034-2017-06910, 0001825034-2017-06911, 0001825034-2017-06912, 0001825034-2017-06913, 0001825034-2017-06914, 0001825034-2017-06125-1. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.
IT WAS REPORTED THE PATIENT IS BEING CONSIDERED FOR REVISION DUE TO INFECTION. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 627159 | G7 ACETABULAR SYSTEM | PROSTHESIS, HIP | JDI | BIOMET ORTHOPEDICS | N/A | 3970984 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Hospitalization| R |