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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. BIOMET HIP SYSTEM 36MM COCR MOD HD +9MM; PROTHESIS, HIP

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ZIMMER BIOMET, INC. BIOMET HIP SYSTEM 36MM COCR MOD HD +9MM; PROTHESIS, HIP Back to Search Results
Model Number N/A
Device Problem Material Erosion (1214)
Patient Problems Pain (1994); Metal Related Pathology (4530)
Event Date 05/03/2023
Event Type  Injury  
Manufacturer Narrative
(b)(4).D10: cat#: 16-104156, lot#: 645350 rnglc+ ltd hole fin shl sz56.Cat#: 103533, lot#: 900690 ti low profile screw 6.5x30mm.Cat#: 51-104150, lot#: 6320163 tprlc 133 t1 pps ho 15x150mm.Cat#: xl-105894, lot#: 544650 arcomxl rlc 10deg 36mm sz24.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.Multiple mdr reports were filed for this event, please see associated reports: 0001825034-2024-00958.
 
Event Description
It was reported that approximately 5 years post implantation of a right total hip arthroplasty, the patient was revised due to, fluid accumulation in the joint, and elevated metal ion levels.During surgery, metallosis was confirmed and determined to be related to the trunnion head interface.The head was removed, and the trunnion was noted to be a very short trunnion with a +9mm head high offset stem, which the surgeon believed predisposed the patient to metallosis.Metallosis was noted around the trunnion with black material on the inside of the head and the trunnion itself.All components were exchanged with competitor product without complications.No additional information was available.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.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.
 
Event Description
Additional information received that approximately 5 months prior to the patient¿s revision, 20ml was aspirated from the right greater trochanteric area due to pain.Numbing medication was injected without steroids.The pain was minimally resolved with injection; however, the pain returned.The patient remained on chronic prednisone therapy.A second injection was planned prior to the revision.No additional information available.
 
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Brand Name
BIOMET HIP SYSTEM 36MM COCR MOD HD +9MM
Type of Device
PROTHESIS, 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 Key19047130
MDR Text Key339433161
Report Number0001825034-2024-00959
Device Sequence Number1
Product Code JDI
UDI-Device Identifier00880304210554
UDI-Public(01)00880304210554(17)281119(10)328680
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K032396
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Consumer,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 04/16/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/04/2024
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue Number11-363665
Device Lot Number328680
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received04/09/2024
Was Device Evaluated by Manufacturer? No
Date Device Manufactured11/19/2018
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 Outcome(s) Required Intervention; Hospitalization;
Patient SexMale
Patient Weight98 KG
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