MAUDE Adverse Event Report: BIOMET ORTHOPEDICS COMPREHENSIVE REVERSE SHOULDER GLENOID BASEPLATE; PROSTHESIS, SHOULDER

Catalog Number 115330

Device Problems Failure To Adhere Or Bond (1031); Migration or Expulsion of Device (1395)

Patient Problem No Information (3190)

Event Type  Injury  

Manufacturer Narrative

(b)(6).Concomitant products: comprehensive reverse central screw: cat#: 115382, lot#: 193940.Comprehensive primary stem: cat#: 113647, lot#: 726560.Comprehensive reverse humeral ti tray: cat#: 115340, lot#: 541900.Humeral bearing: cat#: xl-115363, lot#: 778020.Versa-dial/comp ti taper: cat#: 118001, lot#: 456370.Comprehensive reverse shoulder glenosphere: cat#: 115310, lot#: 823240.Comprehensive locking screw: cat#: 180503, lot#: 988300.Comprehensive locking screw: cat#: 180501, lot#: 153550.Comprehensive reverse fixed locking screw: cat#: 180500, lot#: 153540.The device will not be returned for analysis [remains implanted]; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental medwatch 3500a will be submitted.Multiple mdr reports were filed for this event, please see associated reports: 1825034-2017-02018, 02019.

Event Description

It was reported that a patient underwent an initial shoulder procedure.Approximately 4.5 years subsequent, the central baseplate screw was noted to have broken and baseplate has loosened.No revision has been scheduled.No further information is available.

Manufacturer Narrative

This follow-up report is being submitted to relay additional information.Reported event was confirmed by review of x-rays provided.X-rays show: broken central screw, loose glenoid component, which may have apparently rotated anteriorly, fracture of the acromion, multiple posterior right rib fractures, and generalized osteopenia.Fractures of the acromion and multiple posterior right-sided rib fractures are consistent with a traumatic event, which may have contributed to the reported event of fractured central screw.Device history record (dhr) was reviewed and no discrepancies relevant to the reported event were found.Review of the complaint history determined that no further action(s) is/are required.Root cause was unable to be determined as the necessary information to adequately investigate the reported event was not provided.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

It was reported that a patient underwent an initial shoulder procedure.Approximately 4.5 years subsequent, the central baseplate screw was noted to have broken and baseplate has loosened.No revision has been scheduled.No further information is available.X-rays indicate fractured ribs and acromion, which are consistent with trauma.

• Brand Name: COMPREHENSIVE REVERSE SHOULDER GLENOID BASEPLATE
• Type of Device: PROSTHESIS, SHOULDER
• Manufacturer (Section D): BIOMET ORTHOPEDICS; 56 e. bell drive; warsaw IN 46582
• Manufacturer (Section G): BIOMET ORTHOPEDICS; 56 e. bell drive; warsaw IN 46582
• Manufacturer Contact: christina arnt ; 56 e. bell dr.; warsaw, IN 46582 ; 5745273773
• MDR Report Key: 6436602
• MDR Text Key: 70968001
• Report Number: 0001825034-2017-02018
• Device Sequence Number: 1
• Product Code: PAO
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: PK080642
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,health
• Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date: 10/20/2017

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 03/27/2017
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Physician
• Device Expiration Date: 04/30/2021
• Device Catalogue Number: 115330
• Device Lot Number: 061710
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Date Manufacturer Received: 10/20/2017
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 04/14/2011
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Removal/Correction Number: N/A
• Patient Sequence Number: 1
• Patient Outcome(s): Other
• Patient Weight: 88