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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. UNK STEM; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. UNK STEM; PROSTHESIS, HIP Back to Search Results
Model Number N/A
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Osteopenia/ Osteoporosis (2651)
Event Date 07/13/2023
Event Type  Injury  
Manufacturer Narrative
(b)(4).D10: cat# p0463046 lot# 0001611795 avan cmntd shell ss 46mm; cat# ep-200146 lot# 694590 act artic e1 hip brg 28x40mm; cat# 87-5954 lot# 9269605 s-rom femoral head.G2: foreign: australia multiple mdr reports were filed for this event, please see associated reports: 0002648920 - 2023 - 00178 0002648920 - 2023 - 00179 0001822565 - 2023 - 02058 0001822565 - 2023 - 02059 0002648920 - 2023 - 00174 0001822565 - 2023 - 02061 the 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.
 
Event Description
It was reported that the patient underwent an initial hip procedure.Subsequently, the patient underwent a revision approximately 1 year later due to bone loss.Attempts have been made and no further information has been provided.
 
Event Description
No further information at the time of this report.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Upon reassessment of the reported event, it was determined to be not reportable.The initial report should be voided.
 
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Brand Name
UNK STEM
Type of Device
PROSTHESIS, HIP
Manufacturer (Section D)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer (Section G)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key17452872
MDR Text Key320341169
Report Number0001822565-2023-02060
Device Sequence Number1
Product Code LZO
Combination Product (y/n)N
Reporter Country CodeAS
PMA/PMN Number
N/A
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
Report Date 10/24/2023
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? No
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue NumberUNK STEM
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 07/13/2023
Initial Date FDA Received08/03/2023
Supplement Dates Manufacturer Received10/19/2023
Supplement Dates FDA Received10/26/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
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
Patient Outcome(s) Required Intervention; Hospitalization;
Patient SexFemale
Patient Weight80 KG
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