Current information is insufficient to permit a conclusion as to the cause of the event.Review of device history records show the lot released with no recorded anomaly or deviation.There are warnings in the package insert that state that this type of event can occur: under possible adverse effects, number 6 states, "loosening or migration of the implants can occur due to loss of fixation, trauma, malalignment, bone resorption, and/or excessive activity." number 10 states, "dislocation and subluxation due to inadequate fixation and improper positioning.Muscle and fibrous tissue laxity can also contribute to these conditions." number 14 states, "intraoperative or postoperative bone fracture and/or postoperative pain." this report is number 1 of 2 mdrs filed for the same patient (reference 1825034-2017-00204 / 00205).
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Complaint sample was evaluated and the reported event was confirmed.Inspection of the device showed that the radial head has little to no wear on the articular surface which is expected as the device was only implanted for approximately 6 months.There is no damage observed of the threaded hole of the radial head where the screw goes to attach it to the stem.The radial stem has bony ingrowth indicating it was well-fixed as is noted in the complaint file.There is some damage noted on the screw threads of the stem that may have occurred when the screw loosened or was removed.The screw was observed to have no damage to the threads.The complaint is considered to be confirmed as the three components were returned disassembled from one another.Functionally, the screw was able to be threaded into the stem with no issues.Dhr was reviewed and no discrepancies were found.Review of the complaint history determined that no further action is required as no trends were identified.Root cause was 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.
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