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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER GMBH REVITAN®, DISTAL PART, CURVED, UNCEMENTED, 20/140; HIP IMPLANT

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ZIMMER GMBH REVITAN®, DISTAL PART, CURVED, UNCEMENTED, 20/140; HIP IMPLANT Back to Search Results
Model Number N/A
Device Problem Fracture (1260)
Patient Problems Failure of Implant (1924); Pain (1994); Synovitis (2094); Metal Related Pathology (4530)
Event Date 11/06/2023
Event Type  Injury  
Event Description
It was reported that a patient had a revision surgery due to broken revitan stem.Due diligence is in progress for this complaint; to date no additional information or product has been received.
 
Manufacturer Narrative
(b)(4).D10: revitanâ®, proximal part, cylindrical, uncemented, 65, taper 12/14 item number 0100402065 lot unknown.G2: foreign: germany.The device will not be returned for analysis; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental medwatch will be submitted.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.D10: revitanâ®, proximal part, cylindrical, uncemented, 65, taper 12/14 item number 0100402065 lot 2799951.Product has been received by zimmer biomet and the investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event Description
No additional information at this time.
 
Manufacturer Narrative
His follow-up report is being submitted to relay additional information.D10: revitan®, proximal part, cylindrical, uncemented, 65, taper 12/14 item number 0100402065 lot 2799951.Dural alpha insert w rim oo/32 item number 0100013515 lot 2602123.Sulox-hd 32 l 12/14 item number 173207 lot 2803430.Alloft-s alloclassic shl 64/oo item number 4271 lot #2781144.The revitan stem was returned for investigation and the connection pin of the distal stem is fractured.The sulox head is still mounted on the taper of the proximal part.The sulox head shows some metal transfer on the surface, but it is overall inconspicuous.No bone ongrowth can be seen on the anchoring surface of the proximal part.On the medial and lateral sides, polished areas are visible, indicating possible loosening and movement against the bone.On the anterior and posterior side as well as on the neck of the taper, some scratches are visible, most likely due to revision surgery.The characteristics on the fracture surfaces point to a fatigue fracture with the origin located on the lateral side.Signs of bone attachments can be found on the most distal area of the distal part.The lateral and anterior sides show damage from revision surgery.A review of the device manufacturing records confirmed no abnormalities or deviations.Review of the complaint history identified additional similar complaints for the reported item and the part and lot combination.Complaints are monitored per complaint trending process in order to identify potential adverse trends.Medical records were provided and reviewed by a health care professional.The patient underwent an initial left total hip arthroplasty on unknown date with unknown product due to unknown reason.After that in 2015 the patient had a first revision due to infection and zimmer biomet products were placed.Subsequently, eight (8) years after implantation the patient underwent a second revision surgery due to implant fracture.During the revision implant fracture confirmed.Noted adhesions, bony ingrowth in distal stem and cerclage wires, and metallotic synovitis.The stem, taper, and head were exchanged with competitor components and a zb liner placed without complications.An ap overview of the pelvis taken before second revision surgery was provided and shows implant fracture at the connection pin between the distal and proximal part.Based on the investigation, a fracture of the connection pin of the revitan stem can be confirmed.The characteristics of the fracture surfaces point to a fatigue fracture.The cause may be multifactorial, consisting of patient- and procedure-related factors.Nevertheless, with the information provided, we are unable to provide any definitive conclusions as to the root cause of the reported issue.If any further information is found which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
Event Description
It was reported that patient had a revision surgery due to implant fracture.During the revision implant fracture confirmed, noted adhesions, bony ingrowth in distal stem and cerclage wires, and metallotic synovitis.The stem, taper, and head were exchanged with competitor components and a zimmer biomet liner was placed without complications.Due diligence has been completed for this complaint; to date no additional information has been received.
 
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Brand Name
REVITAN®, DISTAL PART, CURVED, UNCEMENTED, 20/140
Type of Device
HIP IMPLANT
Manufacturer (Section D)
ZIMMER GMBH
sulzer allee 8
sulzer industrie park
winterthur 8404
SZ  8404
Manufacturer (Section G)
ZIMMER GMBH
sulzer allee 8
sulzer industrie park
winterthur 8404
SZ   8404
Manufacturer Contact
christina arnt
56 e. bell dr.
warsaw, IN 46582
5745273773
MDR Report Key18159626
MDR Text Key328399491
Report Number0009613350-2023-00636
Device Sequence Number1
Product Code KWY
UDI-Device Identifier00889024592933
UDI-Public(01)00889024592933(17)200131(10)2786473
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
K192236
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date 05/01/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received11/17/2023
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Expiration Date01/31/2020
Device Model NumberN/A
Device Catalogue Number0100406120
Device Lot Number2786473
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received04/22/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/04/2015
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
Treatment
SEE H10 NARRATIVE.; SEE H11 NARRATIVE.
Patient Outcome(s) Hospitalization; Required Intervention;
Patient SexMale
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