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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. HUMERAL HEAD 45X16; PROSTHESIS, SHOULDER, SEMI CONSTRAINED, METAL/POLYMER, UNCEMENTED/EXTREMITIES

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ZIMMER BIOMET, INC. HUMERAL HEAD 45X16; PROSTHESIS, SHOULDER, SEMI CONSTRAINED, METAL/POLYMER, UNCEMENTED/EXTREMITIES Back to Search Results
Catalog Number SAHH4516
Device Problem Detachment of Device or Device Component (2907)
Patient Problems Hematoma (1884); Pain (1994); Fluid Discharge (2686); Subluxation (4525)
Event Date 10/09/2023
Event Type  Injury  
Manufacturer Narrative
Cmp-(b)(4).Multiple mdr reports were filed for this event, please see associated reports: 0001822565-2024-00498, 0001822565-2024-00500, 0001822565-2024-00501, 0001822565-2024-00502.D10: medical products: item#: sagl2024, 3 peg mono glen sz 4; lot#: 65268604.Item#: sahs1111, humeral stem standard size 11; lot#: 65628117.Item#: sahha001, hum head adapter identity; lot#: 66023931.Item#: sahaf135, hum stem adapter 135 deg; lot#: 66074660.H3: customer has indicated that the product will not be returned to zimmer biomet for investigation, as the product remains implanted in the patient.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event Description
It was reported that the patient underwent an initial total shoulder arthroplasty approximately four (4) and a half months ago.Subsequently, the patient was seen approximately two (2) and a half weeks after the surgery and was complaining of wound drainage and increased pain following a sudden grab of their pants as they were falling down a few days prior to the appointment.On evaluation a hematoma was present, and the patient was prescribed antibiotics.It was noted on x-ray that there was evidence of the implants subluxing.At the patient's six weeks appointment the hematoma had resolved, and the patient reported no further complications.
 
Manufacturer Narrative
(b)(4).This follow-up report is being submitted to relay additional information.Multiple mdr reports were filed for this event, please see associated reports: 0001822565-2024-00498-1, 0001822565-2024-00500-1, 0001822565-2024-00501-1, 0001822565-2024-00502-1.A hematoma is a mass of clotted blood that forms in a tissue, organ, or body space.A hematoma can be associated with pain, swelling, ecchymosis, serosanguinous or bloody drainage after a recent surgical procedure or trauma and can predispose the patient to infection.The development of a postoperative hematoma can be correlated with the surgical procedure and perioperative anticoagulation therapy prescribed to prevent thrombus formation.Most hematomas resolve on their own, without surgical intervention, while some do not.Larger hematomas may need to be surgically evacuated in order to resolve.As timeframes of onset differ due to individual contributing factors, a specific timeframe of expected occurrence cannot be established.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
No further event information available at the time of this report.
 
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Brand Name
HUMERAL HEAD 45X16
Type of Device
PROSTHESIS, SHOULDER, SEMI CONSTRAINED, METAL/POLYMER, UNCEMENTED/EXTREMITIES
Manufacturer (Section D)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer (Section G)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key18699082
MDR Text Key335293514
Report Number0001822565-2024-00499
Device Sequence Number1
Product Code MBF
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K213856
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Study,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 03/01/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/13/2024
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberSAHH4516
Device Lot Number65488726
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received02/29/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured08/15/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention; Hospitalization;
Patient Age70 YR
Patient SexMale
Patient Weight128 KG
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