FDA Adverse Event Injury Summary report: N

E1 RINGLOC ACETABULAR LINER

MDR report key: 7758562 · Received August 7, 2018

Report

Report Number
0001825034-2018-05216
Event Type
Injury
Date Received
August 7, 2018
Date of Event
June 26, 2012
Report Date
August 30, 2018
Manufacturer
ZIMMER BIOMET, INC.
Product Code
JDI
PMA / PMN Number
PK070364
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

CONCOMITANT MEDICAL PRODUCTS: 11-104052 ¿ MALLORY/HEAD ACETABULAR SHELL ¿ 983800, 650-1056 ¿ BIOLOX DELTA CERAMIC HEAD ¿ 735600, UNKNOWN ¿ UNKNOWN STEM - UNKNOWN. REPORTED EVENT WAS CONFIRMED BY REVIEW OF OPERATIVE NOTES AND X-RAYS. REVIEW OF PRE-REVISION X-RAYS CONFIRM A PREVIOUS AVULSION FRACTURE FROM THE SUPERIOR ASPECT OF THE GREATER TROCHANTER. REVIEW OF THE OPERATIVE NOTES CONFIRMS PATIENT REPORT OF DISLOCATION IN CERTAIN POSITIONS WITH LOUD POP, BUT NO PAIN. THE CUP POSITION COULD BE MOVED MORE ANTEVERTED AND THERE ARE AREAS OF TROCHANTER THAT WERE BARE AND NOT HEALED, HOWEVER THE STEM WAS WELL FIXED. DHR WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. 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). REPORTED EVENT WAS UNABLE TO BE CONFIRMED AS PART NUMBER / LOT NUMBER OF DEVICE INVOLVED IN THE INCIDENT IS UNKNOWN. DEVICE HISTORY RECORD REVIEW WAS UNABLE TO BE PERFORMED AS THE LOT NUMBER OF THE DEVICE INVOLVED IN THE EVENT IS UNKNOWN. ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. 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. CONCOMITANT MEDICAL PRODUCTS: ITEM # UNK, STEM, LOT # UNK; ITEM # UNK, HEAD, LOT # UNK; ITEM # UNK, SHELL, LOT # UNK. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034 - 2018 - 05215, 0001825034 - 2018 - 05217.

Description of Event or Problem · 1

IT WAS REPORTED THAT APPROXIMATELY 1 YEAR POST IMPLANTATION, PATIENT UNDERWENT A REVISION DUE TO MALPOSITION OF ACETABULAR CUP THAT LEAD TO MULTIPLE DISLOCATIONS AND SUBLUXATIONS. THE CUP, LINER, HEAD, AND TAPER ADAPTOR WERE REVISED. ATTEMPTS HAVE BEEN MADE AND NO FURTHER INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
598606 E1 RINGLOC ACETABULAR LINER PROSTHESIS, HIP JDI ZIMMER BIOMET, INC. N/A 667220

Patients

Seq Age Sex Outcome Treatment
1 64 YR Hospitalization| R