FDA Adverse Event Injury Summary report: N

MLRY-HD POR FMRL 14X175MM

MDR report key: 7110619 · Received December 12, 2017

Report

Report Number
0001825034-2017-10974
Event Type
Injury
Date Received
December 12, 2017
Report Date
January 17, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LPH
PMA / PMN Number
PK030055
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

UPON REASSESSMENT OF THE REPORTED EVENT, IT WAS DETERMINED THAT THE DEVICE IS NO LONGER RELATED TO THE EVENT AND NO ISSUE HAS BEEN IDENTIFIED. THIS REPORT SHOULD BE VOIDED.

Additional Manufacturer Narrative · 1

(B)(4). MULTIPLE MDR'S WERE SUBMITTED FOR THIS EVENT. PLEASE SEE REPORTS: 0001825034 - 2017 - 10971, 0001825034 - 2017 - 10972, 0001825034 - 2017 - 10973, 0001825034 - 2017 - 10974. CONCOMITANT PRODUCT(S): A 139256 M2A-MAGNUM 42-50 TPR INSRT STD LOT 961970. A 157450 M2A-MAGNUM MOD HD SZ 50MM LOT 760080. US15 7856 M2A-MAGNUM PF CUP 56ODX50ID LOT 869960. A 11-104114 MLRY-HD POR FMRL 14X175MM LOT 256700. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. DEVICE REMAINS IMPLANTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT RIGHT TOTAL HIP ARTHROPLASTY AND IS NOW EXPERIENCING A HERNIA (PATIENT SAID IS RELATED TO DEVICE). WHEN SITTING HE GETS PAIN DOWN THE LEG, THE SURGEON TOLD HIM IT IS THE SWELLING INSIDE HIS LEG PRESSING ON HIS SCIATIC NERVE. HE CAN ONLY WALK SHORT DISTANCES AND HE LIMPS. FEELS LIKE A TOOTH ACHE IN HIS HIP. WHEN SLEEPING AT NIGHT HIS LEG SWELLS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
889708 MLRY-HD POR FMRL 14X175MM PROSTHESIS, HIP LPH ZIMMER BIOMET, INC. N/A 256700

Patients

Seq Age Sex Outcome Treatment
1 76 YR Other