This follow-up report is being submitted to relay additional information.The following sections were updated: b4, b5, g3, g6, h2, h3, h6, h10 upon reassessment of the reported event, it was determined to be not reportable.The initial report was forwarded in error and should be voided.The root cause of the reported event was determined to be unrelated to the implanted zimmer biomet device; therefore, a review of the device history records will not be performed.It was reported a patient underwent a conversion from an anatomical to a reverse total shoulder, three weeks later, due to an unknown infection with slight bone loss.During the investigation process a review of the sterile certifications were reviewed and found to be conforming with no applicable deviations.Devices were verified to have gone through acceptable sterilization process following iso/aami/astm & eu published guidelines.There are multiple factors that may contribute to an infection that are outside the control of zimmer biomet, such as external factors, i.E.Hospital/surgical environment, provider related risk factors, and/or patient comorbidities/risk factors.As there are no indications of a product or process issues identified affecting implant safety or effectiveness, therefore implanted products are not identified as the source or contributing to the reported infection.Bone quality (density, strength & weakness of a bone) is influenced by many internal and external factors.As women age (upon menopause) bone quality is impacted by the decrease in hormones, which places them at risk for osteoporosis.Patients diet, or malabsorption due to different disease processes impacts the bone quality, as the body is not able to absorb the required nutrients to build or maintain bone density.Risk factors that increase a patients poor bone quality, not all inclusive; age, bmi, diet, smoking, alcohol consumption, vitamin intake, such as vitamin d, calcium, magnesium, hormone imbalance impacting the pituitary gland, growth factors, thyroidism & medication associated with treatment, steroid use along with other medications, renal diseases, dialysis, diabetes, blood disorders, trauma, fractures, bone on bone wear, surgical trauma or invasive procedures, repeated joint/bone surgeries resulting in bone loss, infections such as osteomyelitis, necrosis of the bone tissues due to disease processes and genetic history of family members with osteoarthritis or osteoporosis, as a patient¿s bone quality is impacted by many internal and external variables.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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