G7 PPS LTD ACET SHELL 60G
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
(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.
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 |