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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. GLENOSPHERE CENTRIC 36 MM DIAMETER +0 MM LATERAL OFFSET; ZIMMER TRABECULAR METAL REVERSE PLUS SHOULDER SYSTEM GLENOSPHERE 36MM DIAMETER

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ZIMMER BIOMET, INC. GLENOSPHERE CENTRIC 36 MM DIAMETER +0 MM LATERAL OFFSET; ZIMMER TRABECULAR METAL REVERSE PLUS SHOULDER SYSTEM GLENOSPHERE 36MM DIAMETER Back to Search Results
Catalog Number 00436003600
Device Problem Noise, Audible (3273)
Patient Problems Pain (1994); Joint Dislocation (2374)
Event Date 03/27/2024
Event Type  Injury  
Manufacturer Narrative
(b)(4).D10: medical products: item#: 110031419, +3mm thickness 36mm diameter bearing; lot#: 65381485 item#: sahtnem6, -6mm extended neutral humeral tray; lot#: 66046381 h3: 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
It was reported that the patient underwent an initial shoulder reverse shoulder arthroplasty approximately two (2) and a half months ago.The patient was doing great two (2) months post op having no pain and full elevation when the patient reached for a coat in a car and felt a sudden pain and clicking sensation in their shoulder.Subsequently, the surgeon scheduled the patient for a revision of the reverse identity stem.During the revision, it was discovered by the surgeon that the implant was no longer engaged.The implant was free floating in the shoulder joint.
 
Event Description
No further event information available at the time of this report.
 
Manufacturer Narrative
(b)(4).This follow-up report is being submitted to relay additional information.Visual examination of the returned product/provided pictures identified a zimmer tm reverse plus glenosphere was returned for evaluation.The glenosphere was returned with damage to the spherical radius.Review of the device history records identified no deviations or anomalies during manufacturing.Medical records/radiographs were provided and reviewed by a health care professional.Review of the available records identified the following: single ap view of the right shoulder dated 3/28/24 demonstrates narrowing of the glenohumeral joint with metal-on-metal appearance suggesting polyethylene spacer dislocation, with radiolucent spacer possibly within the subacromial sub deltoid space.A definitive root cause cannot 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.
 
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Brand Name
GLENOSPHERE CENTRIC 36 MM DIAMETER +0 MM LATERAL OFFSET
Type of Device
ZIMMER TRABECULAR METAL REVERSE PLUS SHOULDER SYSTEM GLENOSPHERE 36MM DIAMETER
Manufacturer (Section D)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer (Section G)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key19172363
MDR Text Key340915761
Report Number0001822565-2024-01388
Device Sequence Number1
Product Code PHX
UDI-Device Identifier00889024489479
UDI-Public(01)00889024489479(17)331215(10)66323916
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K172767
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 05/23/2024
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
Device Catalogue Number00436003600
Device Lot Number66323916
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/09/2024
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 03/29/2024
Initial Date FDA Received04/24/2024
Supplement Dates Manufacturer Received05/23/2024
Supplement Dates FDA Received05/23/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured12/18/2023
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
SEE H11 NARRATIVE
Patient Outcome(s) Required Intervention; Hospitalization;
Patient Age69 YR
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