MAUDE Adverse Event Report: BIOMET UK LTD. CER BIOLOXD OPTION HD 28MM; BIOLOX DELTA CERAMIC OPTION HD

Model Number N/A

Device Problems Mechanical Problem (1384); Physical Resistance/Sticking (4012)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Date 10/07/2021

Event Type  malfunction  

Manufacturer Narrative

(b)(4).Report source, foreign - event occurred in (b)(6).Customer has indicated that the product is in process of being returned to zimmer biomet for investigation.Concomitant medical products: medical product: e1 ringloc bipolar 28x44mm, catalog no.: 110010461, lot no.: 720070.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 customer reported that he incorporated a delta ceramic head (650-1055) into the e1 bipolar liner, but the head did not move.

Event Description

It was reported, that: the customer reported that he incorporated a delta ceramic head (650-1055) into the e1 bipolar liner, but the head did not move.

Manufacturer Narrative

(b)(4).This final report is being submitted to relay additional information.Complaint summary: adequate photographs have not been provided and product has not been returned for evaluation.Therefore, the investigation has been limited to the information provided, a review of the device history records, and a complaint history search.Review of the device history records identified no deviations or anomalies during manufacturing that could be related to the reported event.Review of complaint history identified (b)(4) additional similar complaints for the reported item and no additional complaints for the reported item and lot combination.This device is used for treatment.The reported event is related to a combination of products; both the head (650-1055 cer bioloxd option hd 28mm) and the associated liner (110010461 e1 ringloc bipolar 28x44mm) are 28mm diameter, and therefore compatible.It has been confirmed that the implant is not within the scope or subject of any field actions or recalls which could be attributed to reported event.The likely condition of the device when it left zimmer biomet is conforming to specification.The reported event has not been confirmed as relevant photographs have not been provided and product has not been returned for evaluation and the dhr review did not identify any issues.The root cause of the reported event cannot be determined with the information provided.Corrective or preventative action not required.The root cause of the reported event cannot be determined with the information provided.The investigation is completed based on current available information.If any additional information becomes available, then the complaint will be reopened and further investigated.H3 other text : requested but not returned by hospital.

Event Description

It was reported, that: the customer reported that he incorporated a delta ceramic head (650-1055) into the e1 bipolar liner, but the head did not move.

Manufacturer Narrative

(b)(4).This follow-up final report is being submitted to relay additional information as the product has been returned for evaluation.A visual inspection shows the surface of the sphere to be in good condition with no damage.A dimensional inspection was conducted and the ceramic biolox d option head 28mm item:650-1055 lot:3062500 was found to be conforming to specification.The likely condition of the device when it left zimmer biomet is conforming to specification.The reported event has not been confirmed as the dimensional inspection shows the product is conforming to specification and the dhr review did not identify any issues.The root cause of the reported event cannot be determined with the information provided.

• Brand Name: CER BIOLOXD OPTION HD 28MM
• Type of Device: BIOLOX DELTA CERAMIC OPTION HD
• 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: 12768312
• MDR Text Key: 282956777
• Report Number: 3002806535-2021-00485
• Device Sequence Number: 1
• Product Code: LZO
• UDI-Device Identifier: 00887868271373
• UDI-Public: 00887868271373
• Combination Product (y/n): N
• Reporter Country Code: JA
• PMA/PMN Number: K192683
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Foreign,Health Professional,Company Representative
• Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup
• Report Date: 04/01/2022

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 Number: N/A
• Device Catalogue Number: 650-1055
• Device Lot Number: 3062500
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: No
• Initial Date Manufacturer Received: 10/21/2021
• Initial Date FDA Received: 11/08/2021
• Supplement Dates Manufacturer Received: 02/08/2022; 03/31/2022
• Supplement Dates FDA Received: 02/09/2022; 04/01/2022
• Was Device Evaluated by Manufacturer?: Yes
• Date Device Manufactured: 05/21/2021
• 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
• Treatment: SEEH10.