MAUDE Adverse Event Report: ZIMMER BIOMET, INC. UNKNOWN +0 NECK LENGTH TAPER ADAPTER; PROSTHESIS, HIP

Device Problems Corroded (1131); Separation Failure (2547); Adverse Event Without Identified Device or Use Problem (2993); Separation Problem (4043)

Patient Problems Cyst(s) (1800); Pain (1994); Osteolysis (2377); Metal Related Pathology (4530)

Event Date 05/03/2021

Event Type  Injury  

Manufacturer Narrative

(b)(4).Multiple mdr reports were filed for this event, please see associated reports: 0001825034-2023-02878 0001825034-2023-02880 d10: unknown magnum head; unknown magnum cup 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.

Event Description

It was reported a patient underwent a left hip revision approximately eleven years post implantation due to abdominal pain, lateral hip tenderness and, laboratory confirmed, elevated metal ion levels.During the revision, periprosthetic osteolysis in the anterosuperior region, a small posterior pseudotumor, anterosuperior bone cyst, osteolytic defect and the head was cold welded.The head and taper were removed and replaced without complication.Attempts have been made and no further information is available.

Event Description

No additional event information to report at this time.

Manufacturer Narrative

(b)(4).This follow-up report is being submitted to relay additional information.No product was returned or pictures provided; visual and dimensional evaluations could not be performed.Device history record (dhr) review was unable to be performed as the lot number of the device involved in the event is unknown.Medical records/radiographs were provided and reviewed by a health care professional.A review of the available records identified findings of the reported issues.Failed left tha with periprosthetic osteolysis (anterosuperior region) and posterior pseudotumor (intracapsular ¿ posterior, quite small).Cobalt chromium levels elevated.The compliant is confirmed based on the evaluation of the provided medical records.A definitive root cause is 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.

• Brand Name: UNKNOWN +0 NECK LENGTH TAPER ADAPTER
• 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 Key: 18265296
• MDR Text Key: 329669961
• Report Number: 0001825034-2023-02879
• Device Sequence Number: 1
• Product Code: LPH
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: N/A
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Consumer,Health Professional,Distributor
• Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date: 01/04/2024

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: No
• Initial Date Manufacturer Received: 11/09/2023
• Initial Date FDA Received: 12/05/2023
• Supplement Dates Manufacturer Received: 12/22/2023
• Supplement Dates FDA Received: 01/05/2024
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention; Hospitalization
• Patient Sex: Female