MAUDE Adverse Event Report: BIOMET UK LTD. 36MM COCR BIOMET FEM HD -3 NK; PROSTHESIS, HIP

Model Number N/A

Device Problem Insufficient Information (3190)

Patient Problems Pain (1994); Ambulation Difficulties (2544)

Event Date 02/12/2016

Event Type  Injury  

Manufacturer Narrative

(b)(4).Concomitant medical products: 22-301302 arcos con sz b std 60mm ha 303880, 22-300916 arcos 16x190mm spl tpr dist ha 379520, pt-106056 regen/rnglc+ multi 56mm sz 24 389700, ep-105894 epoly rlc 36mm 10deg sz24 sz24 437480, 103531 ti low profile screw 6.5x20mm 3106140, 103532 bm acet lp dome scw ti s/tap dia6.5x25mm 3127304, 103533 ti low profile screw 6.5x30mm 3154823, 350806 2.0 mm ss cable/sleeve combo 283490, 350806 2.0 mm ss cable/sleeve combo 203530, 350806 2.0 mm ss cable/sleeve combo 111410.Report source: foreign.The event occurred in (b)(6).G4: this report is being submitted late as it has been identified in remediation.Reported event was unable to be confirmed due to limited information received from the customer.Dhr was reviewed and no discrepancies were found.Review of the complaint history determined that no further action is required as no were trends identified.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 the patient underwent initial right hip surgery on an unknown date and was revised due to loosening (b)(6) 2014.Subsequently patient experienced problems walking about, problems washing or dressing, moderate pain (may take aspirin), a moderate limp, moderate trouble getting in or out of the car, moderate difficulty putting on socks, noted it was impossible to shop, extremely difficult to climb stairs, moderately painful to stand up, and unable to perform usual activities at 3 year follow up visit on 12 feb 2016.The patient was also using 2 crutches or a walker at the 3 year visit.

• Brand Name: 36MM COCR BIOMET FEM HD -3 NK
• Type of Device: PROSTHESIS, HIP
• Manufacturer (Section D): BIOMET UK LTD.; waterton industrial estates; bridgend CF31 3XA; UK CF31 3XA
• Manufacturer (Section G): BIOMET UK LTD.; waterton industrial estates; bridgend CF31 3XA; UK CF31 3XA
• Manufacturer Contact: christina arnt ; 56 e. bell dr.; warsaw, IN 46582 ; 5745273773
• MDR Report Key: 7851686
• MDR Text Key: 119398738
• Report Number: 3002806535-2018-01060
• Device Sequence Number: 1
• Product Code: HRY
• Combination Product (y/n): N
• Reporter Country Code: SP
• PMA/PMN Number: PN/A
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: foreign,health professional,s
• Reporter Occupation: Physician
• Type of Report: Initial
• Report Date: 09/06/2018

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?: No
• Device Operator: Health Professional
• Device Expiration Date: 07/31/2022
• Device Model Number: N/A
• Device Catalogue Number: 650-0840
• Device Lot Number: 2754109
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 05/09/2016
• Initial Date FDA Received: 09/06/2018
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 07/23/2012
• 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 Age: 65 YR
• Patient Weight: 60