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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. VIVACIT-E DM LINER 28 X 38MM; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. VIVACIT-E DM LINER 28 X 38MM; PROSTHESIS, HIP Back to Search Results
Model Number N/A
Device Problem Device Markings/Labelling Problem (2911)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 08/12/2020
Event Type  malfunction  
Manufacturer Narrative
(b)(4).Product has been received by zimmer biomet and the investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event Description
It was reported the wrong implant was in the dual mobility active articulation head box during an initial hip arthroplasty.They opened a 38mm size c for a 48 cup and there was a 42mm in the box which goes with a 52mm cup.The device was implanted but detected there was an issue.They used a caliper, after taking the head off and measured it, they saw it was 4mm's bigger than it was supposed to be.They opened another 38mm poly ball e1 active articulation and it was the correct size.No complications or harm for the patient.Attempts have been made and additional information on the reported event is unavailable at this time.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections were updated/corrected updated: g4; h2; h3; h6.Complaint confirmed.Visual review of the device shows no damage to the liner.Item and lot are not etched on the device and unable to be confirmed.The product identifier for overall height and width were measured and show the device non-conforming to 38mm specification.The dimensions for product identifiers do however fall within specification for a 42mm liner.Radiographs were provided and reviewed by a health care professional.Coob confirmed intra/post op and there are additional complaints for the part and lot combination for same/similar issue.Review of the device history record(s) identified no deviations or anomalies during manufacturing.The root cause of the reported issue is attributed to a manufacturing deficiency.The event is being farther investigated through the capa process.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 additional information on the reported event.
 
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Brand Name
VIVACIT-E DM LINER 28 X 38MM
Type of Device
PROSTHESIS, HIP
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
MDR Report Key10489698
MDR Text Key205697769
Report Number0001822565-2020-03145
Device Sequence Number1
Product Code LPH
UDI-Device Identifier00889024572676
UDI-Public(01)00889024572676
Combination Product (y/n)N
PMA/PMN Number
K190656
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,distri
Type of Report Initial,Followup
Report Date 09/04/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue Number110031009
Device Lot Number64755636
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/01/2020
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 08/12/2020
Initial Date FDA Received09/03/2020
Supplement Dates Manufacturer Received09/04/2020
Supplement Dates FDA Received09/08/2020
Is This a Reprocessed and Reused Single-Use Device? No
Removal/Correction NumberNI
Patient Sequence Number1
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