BEUDAMED
    FDA Adverse Event Injury Summary report: N

    G7 DUAL MOBILITY LINER 38MM C

    MDR report key: 8653835 · Received May 30, 2019

    Report

    Report Number
    0001825034-2019-02352
    Event Type
    Injury
    Date Received
    May 30, 2019
    Date of Event
    January 11, 2019
    Report Date
    November 5, 2019
    Manufacturer
    ZIMMER BIOMET, INC.
    Product Code
    LPH
    PMA / PMN Number
    K150522
    Removal / Correction Number
    N/A
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 0

    MEDICAL RECORDS WERE PROVIDED AND REVIEWED BY A HEALTH CARE PROFESSIONAL. REVIEW OF THE AVAILABLE RECORDS IDENTIFIED THE FOLLOWING: CONTRIBUTING FACTORS OF EVENT: PATIENT HISTORY OF RECREATIONAL DRUG ABUSE AND ALCOHOL INTAKE. MILD MYOCARDIAL INFARCTION, NAUSEA AND VOMITING, PER PATIENT REPORT, RECORDS ARE LIMITED. 3 NIGHTS HOSPITALIZATION, FLUIDS AND ELECTROLYTES, ELECTIVE CARDIAC CATHETERIZATION. REPORTED EVENT WAS CONFIRMED BY REVIEW OF MEDICAL RECORDS PROVIDED. DEVICE HISTORY RECORD WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. ROOT CAUSE WAS UNABLE TO BE DETERMINED. 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 · 0

    NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

    Additional Manufacturer Narrative · 1

    (B)(4). CONCOMITANT MEDICAL PRODUCTS: CATALOG NUMBER: 00625006535, LOT NUMBER:64190171, BRAND NAME: BONE SCREW; CATALOG NUMBER:00625006525, LOT NUMBER:64124990, BRAND NAME: BONE SCREW; CATALOG NUMBER: 00877502802, LOT NUMBER: 2960402, BRAND NAME: BIOLOX DELTA CERAMIC HEAD; CATALOG NUMBER: 00771100910, LOT NUMBER:63994695, BRAND NAME: M/L TAPER STEM; CATALOG NUMBER:010000661, LOT NUMBER:3442540, BRAND NAME: G7 ACETABULAR SHELL; CATALOG NUMBER:XL-200144, LOT NUMBER: 332220, BRAND NAME: ACT ARTIC HD ARCOM. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2019-02351, 0001825034-2019-02353. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. DEVICE REMAINS IMPLANTED IN THE PATIENT.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PATIENT UNDERWENT HOSPITALIZATION AND A CARDIAC CATHETERIZATION DUE TO MYOCARDIAL INFARCTION APPROXIMATELY 44 DAYS POST IMPLANTATION. ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE AT THIS TIME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    449102 G7 DUAL MOBILITY LINER 38MM C PROSTHESIS, HIP LPH ZIMMER BIOMET, INC. N/A 599730

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Hospitalization