MAUDE Adverse Event Report: ZIMMER BIOMET, INC. COMP NLK SCR 3.5HEX 4.75X30 ST; EXTREMITIES IMPLANTS

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  

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.

Manufacturer Narrative

(b)(4).G2: france.Concomitant medical products: catalog #: 110032430, comp aug mini bsplt w tpr lg, lot # 64836356 catalog #: 115313, comp rvsr shldr glnsp +3 36mm, lot # 245030 catalog #: 180561, comp nlk scr 3.5hex 4.75x35 st, lot # 093390 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 customer has indicated that the product will not be returned to zimmer biomet for investigation, as its location is unknown.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.Multiple mdr reports were filed for this event, please see associated reports: 0001825034-2023-00453, 0001825034-2023-00454, 0001825034-2023-00455, 0001825034-2023-00757.

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.

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.

• Brand Name: COMP NLK SCR 3.5HEX 4.75X30 ST
• 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 Key: 16685026
• MDR Text Key: 312728736
• Report Number: 0001825034-2023-00756
• Device Sequence Number: 1
• Product Code: KWS
• UDI-Device Identifier: 00880304677272
• UDI-Public: (01)00880304677272(17)301120(10)380220
• Combination Product (y/n): N
• Reporter Country Code: FR
• PMA/PMN Number: K080642
• 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
• 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 Number: N/A
• Device Catalogue Number: 180560
• Device Lot Number: 380220
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: No
• Initial Date Manufacturer Received: 03/17/2023
• Initial Date FDA Received: 04/05/2023
• Supplement Dates Manufacturer Received: 08/16/2023
• Supplement Dates FDA Received: 08/18/2023
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 11/20/2020
• 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
• Patient Outcome(s): Required Intervention; Hospitalization