FDA Adverse Event Injury Summary report: N

G7 ACETABULAR LINER

MDR report key: 8915857 · Received August 21, 2019

Report

Report Number
0001825034-2019-03584
Event Type
Injury
Date Received
August 21, 2019
Report Date
December 17, 2019
Manufacturer
ZIMMER BIOMET, INC.
Product Code
OQG
PMA / PMN Number
K150522
Removal / Correction Number
N/A
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. UDI #: (B)(4). CONCOMITANT MEDICAL PRODUCTS: ITEM #: EP-200146, LOT #: 593720, HIP BEARING; ITEM #: 110024462, LOT #: 921750, LINER; ITEM #: 010000661, G7 ACETABULAR SHELL, LOT #: 6289138; ITEM #: 51-107110, TAPERLOC COMPLETE MICRO FEMORAL STEM, LOT #: 6278522. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING THAT WOULD CONTRIBUTE TO THIS EVENT. 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.

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: ITEM #650-1056 BIOLOX DELTA CERAMIC HEAD LOT #2898743, ITEM # 010000661 G7 ACETABULAR SHELL LOT # 6289138, ITEM #51-107110 TAPERLOC COMPLETE MICRO FEMORAL STEM LOT #6278522. CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ZIMMER BIOMET FOR INVESTIGATION, AS PRODUCT REMAINS IMPLANTED. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034 -2019 -03587.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT IS EXPERIENCING LIMITED RANGE OF MOTION AFTER UNDERGOING LEFT HIP REVISION PROCEDURE. ADDITIONAL INFORMATION WAS REQUESTED HOWEVER, NONE WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
710082 G7 ACETABULAR LINER PROSTHESIS, HIP OQG ZIMMER BIOMET, INC. 921750

Patients

Seq Age Sex Outcome Treatment
1 Other