FDA Adverse Event Injury Summary report: N

RINGLOC ACETABULAR LINER

MDR report key: 7546483 · Received May 25, 2018

Report

Report Number
0001825034-2018-03638
Event Type
Injury
Date Received
May 25, 2018
Date of Event
May 4, 2018
Report Date
October 12, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LPH
PMA / PMN Number
PK970501
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

UPON REASSESSMENT OF THE REPORTED EVENT, THIS REPORT SHOULD BE VOIDED AS IT WAS DETERMINED TO BE A DUPLICATE OF MFR NUMBER 0001825034-2018-03570.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS- MALLORY HEAD RADIAL POROUS COATED SHELL # ITEM 13-104052 LOT 523550, CO-CR MODULAR HEAD COMPONENT # ITEM 163620 LOT 437050, MALLORY HEAD PRESS FIT FEMORAL TAPER STEM # ITEM 11-104109 LOT 562590. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2018-03636, 0001825034-2018-03637 AND 0001825034-2018-03634. IT IS UNKNOWN IF PRODUCT WILL BE RETURNING TO ZIMMER BIOMET AND THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT REVISION SURGERY 16 YEARS POST INITIAL SURGERY DUE TO UNKNOWN REASONS. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
387215 RINGLOC ACETABULAR LINER PROSTHESIS HIP LPH ZIMMER BIOMET, INC. N/A 385280

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R