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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. COMP AUG MINI BSPLT W TPR LG; EXTREMITIES IMPLANTS

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ZIMMER BIOMET, INC. COMP AUG MINI BSPLT W TPR LG; EXTREMITIES IMPLANTS Back to Search Results
Model Number N/A
Device Problems Fracture (1260); Migration or Expulsion of Device (1395)
Patient Problems Bacterial Infection (1735); Failure of Implant (1924); Foreign Body In Patient (2687)
Event Date 04/12/2022
Event Type  Injury  
Manufacturer Narrative
(b)(4).Concomitant medical products: catalog #: 115313, comp rvsr shldr glnsp +3 36mm, lot # unknown.Catalog #: unknown, screw, lot # unknown.Report source: france.The customer has not indicated whether the product will be returned to zimmer biomet for investigation or not.Once this information is obtained a follow-up mdr will be submitted.Multiple mdr reports were filed for this event, please see associated reports: 0001825034-2023-00454, 0001825034-2023-00455.
 
Event Description
It was reported that the patient had an initial surgery approximately 3 years ago, subsequently the patient had a revision for the removal of the glenosphere implant, during the surgery a fractured screw was partially removed; however, some of the screw remained in the glenoid.Also, the bacteriology was positive for cuti acnes, but no intraoperative septic signs, nor pain before the breakage of the material.Attempts have been made and there is no further information at this time.
 
Event Description
No further event information available at the time of this report.
 
Manufacturer Narrative
(b)(4).Medical product: catalog #: 115313, comp rvsr shldr glnsp +3 36mm, lot # 245030.Catalog #: 180561, comp nlk scr 3.5hex 4.75x35 st, lot # 093390.Catalog #: 180560, comp nlk scr 3.5hex 4.75x30 st, lot # 380220.Catalog #: 180559, comp nlk scr 3.5hex 4.75x25 st, lot # 376920.Catalog #: 00434903603, 36mm ã¿ +3mm offset poly line, lot # 64687488.Catalog #: 00434901413, 14mm ã¿ 130mm length humeral stem, lot # 64759385.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.Multiple mdr reports were filed for this event, please see associated reports: 0001825034-2023-00454, 0001825034-2023-00455, 0001825034-2023-00756, 0001825034-2023-00757.
 
Event Description
It was reported that the patient had an initial surgery approximately 3 years ago, subsequently they then had a revision for the removal of the glenosphere implant and baseplate pullout.During the revision there was a broken screw that was partially removed, however some the screw remained in the glenoid.Also, the bacteriology was positive for cuti acnes, but there were no intraoperative septic signs, nor pain before the breakage of the material.Attempts have been made and there is no further information at this time.
 
Manufacturer Narrative
(b)(4).Reported event was confirmed as visual examination of the provided photos show the screws holding the baseplate had broken.Further examination was not completed as the products were not returned.Medical records/radiographs identified the following: significant findings include three separate fracture screw fragments within the glenoid with bone erosion along the glenoid could represent evidence of patient infection.Overall fit and alignment of implants on post-op images is appropriate.Mild osteopenia is present.Device history record was reviewed and no discrepancies relevant to the reported event were found.A definitive root cause could not be determined for the fractured screws.The root cause of the infection was determined to be unrelated to the implanted zimmer biomet device.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.
 
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Brand Name
COMP AUG MINI BSPLT W TPR LG
Type of Device
EXTREMITIES IMPLANTS
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 Key16487154
MDR Text Key310717663
Report Number0001825034-2023-00453
Device Sequence Number1
Product Code KWS
UDI-Device Identifier00880304993259
UDI-Public(01)00880304993259(17)250723(10)64836356
Combination Product (y/n)N
Reporter Country CodeFR
PMA/PMN Number
K172502
Number of Events Reported1
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 08/18/2023
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 Model NumberN/A
Device Catalogue Number110032430
Device Lot Number64836356
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 02/23/2023
Initial Date FDA Received03/06/2023
Supplement Dates Manufacturer Received03/17/2023
08/16/2023
Supplement Dates FDA Received04/05/2023
08/18/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured07/23/2020
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Removal/Correction NumberN/A
Patient Sequence Number1
Treatment
SEE H10
Patient Outcome(s) Required Intervention; Hospitalization;
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