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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. EXPLOR 8X28MM IMPL STEM W/SCR; PROSTHESIS, ELBOW, HEMI-, RADIAL, POLYMER

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ZIMMER BIOMET, INC. EXPLOR 8X28MM IMPL STEM W/SCR; PROSTHESIS, ELBOW, HEMI-, RADIAL, POLYMER Back to Search Results
Catalog Number 11-210063
Device Problems Detachment of Device or Device Component (2907); Adverse Event Without Identified Device or Use Problem (2993); Noise, Audible (3273)
Patient Problems Failure of Implant (1924); Pain (1994); Loss of Range of Motion (2032); Swelling/ Edema (4577)
Event Type  Injury  
Manufacturer Narrative
(b)(4), multiple mdr reports were filed for this event.Please see the associated report: 0001825034-2023-02189.D10: unknown explor head, lot unknown.The customer has indicated that the product will not be returned to zimmer biomet for investigation as the product remains implanted.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.A supplemental will be filed accordingly if any further information is found that would change or alter any conclusions or information.Zimmer biomet will continue to monitor for trends.
 
Event Description
It was reported the patient underwent a left arm procedure approximately six (6) years ago.The patient is now reported to be experiencing extreme pain.However, no revision procedure or further intervention has been reported to date.Attempts have been made, and no further information has been provided.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.D10: item# 11-210032; lot# 034410.If any further information which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
Event Description
It was reported that the patient underwent a trauma procedure approximately six (6) years and four (4) months ago following a fall that fractured the left ulnar and radial head of the humerus.Subsequently, the patient began experiencing pain, decreased rom, swelling and noise approximately five (5) years and six (6) months post-implantation.X-ray images were taken approximately six (6) months ago and revealed radial head had disassociated from stem and progression of arthritis was noted.Attempts have been made and no further information has been provided.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.H6: proposed component code: mechanical (g04)- stem.No product was returned or pictures provided; visual and dimensional evaluations could not be performed.Medical records were provided and reviewed by a health care professional.Review of the available records identified the following: (b)(6) 2023 xray progressed arthritis, effusion, dissociation (disengaged) of radial head from radial prosthesis.Xray notes good alignment of ulna.Left elbow pain 7/10, swelling pain, decreased rom, symptoms begun (b)(6) 2022.No trauma, pain with rotation of arm and clicking.Discussed plan : will need revision surgery and will call when he wants surgery.Review of the device history record(s) identified no deviations or anomalies during manufacturing related to the reported event.A definitive root cause cannot be determined.If any further information which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
Event Description
No further event information available at the time of this report.
 
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Brand Name
EXPLOR 8X28MM IMPL STEM W/SCR
Type of Device
PROSTHESIS, ELBOW, HEMI-, RADIAL, POLYMER
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer (Section G)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key17795189
MDR Text Key324003232
Report Number0001825034-2023-02190
Device Sequence Number1
Product Code KWI
UDI-Device Identifier00880304210462
UDI-Public(01)00880304210462(17)260308(10)209490
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K040611
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Consumer,Health Professional
Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date 02/09/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/21/2023
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue Number11-210063
Device Lot Number209490
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received02/08/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured03/08/2016
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Removal/Correction NumberNI
Patient Sequence Number1
Treatment
SEE NARRATIVE IN H10; SEE NARRATIVE IN H10.
Patient Outcome(s) Other;
Patient SexMale
Patient Weight116 KG
Patient EthnicityNon Hispanic
Patient RaceWhite
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