FDA Adverse Event Injury Summary report: N

G7 PPS LTD ACET SHELL 62H

MDR report key: 7194883 · Received January 16, 2018

Report

Report Number
0001825034-2018-00033
Event Type
Injury
Date Received
January 16, 2018
Date of Event
December 21, 2017
Report Date
April 11, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JDI
PMA / PMN Number
PK121874
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: 010000860, G7 NEUTRAL E1 LINER 36 MM H, 3387429. 010000743, G7 NEUTRAL ARCOMXL LNR 36 MM H, 3912280. PRODUCT HAS BEEN RECEIVED BY ZIMMER BIOMET AND 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 REPORTS: 0001825034-2018-00034, 0001825034-2018-00035.

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. COMPLAINT SAMPLE WAS EVALUATED AND THE REPORTED EVENT WAS CONFIRMED. VISUAL INSPECTION OF THE SHELL FOUND VARIOUS INSTANCES OF DAMAGE. SUPERFICIAL SURFACE SCRATCHES CAN BE SEEN ON THE OUTER RIM. A SMALL DING CAN ALSO BE SEEN ON THE RIM. SCRATCHES WERE ALSO OBSERVED ON THE INSIDE OF SHELLS DOME. THE OBSERVED DAMAGE IS ATTRIBUTED TO ATTEMPTS TO IMPACT AND REMOVE THE LINERS. THE SQUARE FEATURE ALSO EXHIBITS FOUR MARKS OF DEFORMATION. THIS DEFORMATION APPEARS TO HAVE BEEN CAUSED BY A CLOCKWISE TORQUEING MOTION OF THE SHELL INSERTER. NO DAMAGE, DEFORMATION, OR FOREIGN DEBRIS WAS OBSERVED ON THE LOCKING GROOVE. THE SCALLOPS WERE ALSO FREE FROM ANY DAMAGE. DIMENSIONAL ANALYSIS PERFORMED DID NO IDENTIFY ANY DISCREPANCIES THAT WOULD CONTRIBUTE TO THE REPORTED EVENT. DEVICE HISTORY RECORD WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. REVIEW OF COMPLAINT HISTORY DETERMINED THAT NO FURTHER ACTION(S) IS/ARE REQUIRED. ROOT CAUSE WAS UNABLE TO BE DETERMINED. A SUMMARY OF THE INVESTIGATION HAS BEEN SENT TO THE COMPLAINANT. 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.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A LEFT HIP PROCEDURE, THE LINER WOULD NOT SEAT IN THE ACETABULAR SHELL. A SECOND LINER WAS ATTEMPTED, WITH THE SAME RESULTS. THE CUP WAS REMOVED FROM THE PATIENT AND ANOTHER IMPLANT WAS UTILIZED TO COMPLETE THE PROCEDURE. THERE WAS A DELAY OF APPROXIMATELY THIRTY (30) MINUTES AS A RESULT. NO FURTHER PATIENT CONSEQUENCES WERE REPORTED. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A LEFT HIP PROCEDURE THE LINER WOULD NOT SEAT IN THE SHELL. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
39816 G7 PPS LTD ACET SHELL 62H PROSTHESIS, HIP JDI ZIMMER BIOMET, INC. N/A 3831312

Patients

Seq Age Sex Outcome Treatment
1 69 YR Required Intervention