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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. SM HYBRID GLENOID BASE 4MM; PROSTHESIS, SHOULDER, SEMI-CONSTRAINED, METAL/POLYMER CEMENTED

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ZIMMER BIOMET, INC. SM HYBRID GLENOID BASE 4MM; PROSTHESIS, SHOULDER, SEMI-CONSTRAINED, METAL/POLYMER CEMENTED Back to Search Results
Catalog Number 113952
Device Problems Unstable (1667); Naturally Worn (2988); Noise, Audible (3273)
Patient Problems Arthritis (1723); Failure of Implant (1924); Pain (1994); Subluxation (4525); Joint Laxity (4526); Muscle/Tendon Damage (4532)
Event Date 12/27/2022
Event Type  Injury  
Event Description
It was reported a patient underwent a left shoulder revision approximately four(4) years post implantation due to posterior instability, pain and noise.During the revision the left shoulder was found to have degenerative joint disease, rotator cuff arthropathy, an irreparable rotator cuff tear, and sub luxation of humeral head.All components, except the humeral stem, were removed and replaced with zimmer biomet product.Attempts have been made and no further information has been provided.
 
Manufacturer Narrative
(b)(4).Customer has indicated that the product will not be returned to zimmer biomet for investigation.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.Zimmer biomet will continue to monitor for trends.Associated products and reports: 0001825034-2023-00168, item#pt-113950; lot#960770.0001825034-2023-00169, item#113048; lot#572420.0001825034-2023-00170, item#118001; lot#057540.Other associated products: item#113653; lot#987670, item#110008096; lot#934310, item#110005307; lot#299460, item#405669; lot#127800, item#110003484; lot#336600, item#110005306; lot#614850.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.No product was returned or pictures provided; visual and dimensional evaluations could not be performed.Medical records and radiographs were provided and reviewed by a health care professional.Review of the available records identified the following: abnormal alignment (posterior subluxation) of the humeral head with respect to the glenoid.There is suggestion that this could be present on the frontal view as there is possible slightly increased spacing of the glenonhumeral joint without overlapping of the humerus with the acetabulum; however, this can also be technical in nature.Overall fit and bone quality likely normal with exception of periprosthetic lucency surrounding the glenoid screw.The screw may be slightly subluxed deep to the articular surface of the glenoid.No instability found besides the abnormal alignment which could cause the hardware to come into contact and cause noise.Evaluation of rotator cuff arthropathy and rotator cuff tear cannot be performed radiographically; only by mri or ct arthrogram can this be done.In a situation of a massive full thickness rotator cuff tear, there is often loss of the subacromial space; however, this is not seen on this radiograph.Assessment for degenerative joint disease is not an assessment to be made with an arthroplasty, as the joint space has been replaced by hardware.Dhr was reviewed and no discrepancies relevant to the reported event were found.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
SM HYBRID GLENOID BASE 4MM
Type of Device
PROSTHESIS, SHOULDER, SEMI-CONSTRAINED, METAL/POLYMER CEMENTED
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 Key16270821
MDR Text Key308446547
Report Number0001825034-2023-00172
Device Sequence Number1
Product Code KWS
UDI-Device Identifier00880304462625
UDI-Public(01)00880304462625(17)220809(10)539300
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K060694
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Distributor
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 08/09/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date08/09/2022
Device Catalogue Number113952
Device Lot Number539300
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 01/03/2023
Initial Date FDA Received01/31/2023
Supplement Dates Manufacturer Received08/01/2023
Supplement Dates FDA Received08/09/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured08/09/2017
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
Patient Outcome(s) Hospitalization; Required Intervention;
Patient SexMale
Patient Weight97 KG
Patient EthnicityHispanic
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