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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. G7 HI-WALL ARCOMXL LNR 40MM I; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. G7 HI-WALL ARCOMXL LNR 40MM I; PROSTHESIS, HIP Back to Search Results
Model Number N/A
Device Problem Difficult to Insert (1316)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/26/2023
Event Type  malfunction  
Event Description
It was reported that the liner would not seat down.The doctor made sure the screw was seated all the way and that all soft tissue was out of the way.He still could not get the liner seated into the cup.The surgeon had to use a neutral liner.There was no known impact or consequences to the patient.Attempts have been made and no further information has been provided.
 
Manufacturer Narrative
(b)(4).The customer has indicated that the product will not be returned to zimmer biomet for investigation as its location is unknown.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event Description
There is no update to the prior event description provided.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections were updated/corrected.Updated: b4, d4: expiration date and udi, g3, g6, h2, h4, h6, h10 visual examination of the provided picture identified one of the liners in a bag with some bio-debris noted to the surface.No further evaluation can be made from the picture.Review of the device history records identified no deviations or anomalies during manufacturing.A definitive root cause cannot be determined for the liner not seating properly 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.
 
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Brand Name
G7 HI-WALL ARCOMXL LNR 40MM I
Type of Device
PROSTHESIS, HIP
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer (Section G)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key16945381
MDR Text Key315371139
Report Number0001825034-2023-01057
Device Sequence Number1
Product Code PBI
UDI-Device Identifier00880304526174
UDI-Public(01)00880304526174(17)230915(10)6379347
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K121874
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Distributor
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 10/20/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/17/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date09/15/2023
Device Model NumberN/A
Device Catalogue Number010000828
Device Lot Number6379347
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received10/19/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured09/30/2018
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Removal/Correction NumberN/A
Patient Sequence Number1
Patient SexMale
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