FDA Adverse Event Injury Summary report: N

G7 PPS LTD ACET SHELL 60G

MDR report key: 7298712 · Received February 27, 2018

Report

Report Number
0001825034-2018-01500
Event Type
Injury
Date Received
February 27, 2018
Date of Event
November 1, 2016
Report Date
February 26, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
PBI
PMA / PMN Number
PK121874
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). MEDICAL DEVICES: 192016, ECHO POR FMRL NC 16X160MM, 890370, 650-1161, DELTA CER FEM HD 32/+3MM T1, 2015110160, 110003629, BIOLOX DELTA CER LNR 32MM G, 3181271. REPORT SOURCE, FOREIGN - THE EVENT OCCURRED IN (B)(6). REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. THE PRODUCT WAS NOT RETURNED FOR THE INVESTIGATION, THEREFORE A VISUAL AND DIMENSIONAL EVALUATIONS COULD NOT BE PERFORMED. DHR WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORT EVENT WAS NOT REPORTED. 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 REPORT IS BEING SUBMITTED LATE AS IT HAS BEEN IDENTIFIED IN REMEDIATION. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034 - 2018 - 01499.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT A LEFT HIP PROCEDURE. SUBSEQUENTLY, THE PATIENT REPORTED EPISODES OF SEVERE PAIN THAT MAY REQUIRE THE USE OF MEDICATION STRONGER THAN AN ASPIRIN DURING THREE MONTHS WHICH DECREASED TO MILD AND MODERATE PAIN DURING ONE YEAR FOLLOW UP VISIT. THE PATIENT ALSO REPORTED A MODERATE LIMP THAT REQUIRED A CANE FOR SUPPORT AND DIFFICULTY WITH DAILY ACTIVITIES DURING THREE MONTH FOLLOW UP VISIT. THE SLIGHT LIMP DID NOT REQUIRE ANY SUPPORT. SATISFACTORY RATING OF 9 WAS REPORTED DURING ONE YEAR POST OP VISIT. NO FURTHER INFORMATION WAS PROVIDED, AND THE PATIENT'S OUTCOME IS UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
144038 G7 PPS LTD ACET SHELL 60G PROSTHESIS, HIP PBI ZIMMER BIOMET, INC. N/A 3795399

Patients

Seq Age Sex Outcome Treatment
1 69 YR Other| R