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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER GMBH BIOLOX DELTA, CERAMIC FEMORAL HEAD, M, ø 36/0, TAPER 12/14; HIP IMPLANT

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ZIMMER GMBH BIOLOX DELTA, CERAMIC FEMORAL HEAD, M, ø 36/0, TAPER 12/14; HIP IMPLANT Back to Search Results
Model Number N/A
Device Problem Biocompatibility (2886)
Patient Problem Post Operative Wound Infection (2446)
Event Date 03/02/2024
Event Type  Injury  
Manufacturer Narrative
(b)(4).G2: foreign: australia.The device will not be returned for analysis; however, an investigation of the reported event is in progress.Once the investigation is completed, a follow-up mdr will be submitted.
 
Event Description
It was reported the patient had a revision surgery approximately one month post-implantation due to redness around surgical wound.There was an irrigation and debridement with exchange of the femoral head.Due diligence is in progress for this complaint; to date no additional information or product has been received.
 
Manufacturer Narrative
Upon reassessment of the reported event, it was determined to be not reportable as it was confirmed that the reported event was unrelated to the reported zb device.The initial report was forwarded in error and should be voided.
 
Event Description
Upon reassessment of the reported event, it was determined to be not reportable.The initial report was forwarded in error and should be voided.
 
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Brand Name
BIOLOX DELTA, CERAMIC FEMORAL HEAD, M, ø 36/0, TAPER 12/14
Type of Device
HIP IMPLANT
Manufacturer (Section D)
ZIMMER GMBH
sulzer allee 8
sulzer industrie park
winterthur 8404
SZ  8404
Manufacturer (Section G)
ZIMMER GMBH
sulzer allee 8
sulzer industrie park
winterthur 8404
SZ   8404
Manufacturer Contact
christina arnt
56 e. bell dr.
warsaw, IN 46582
5745273773
MDR Report Key18928756
MDR Text Key337981172
Report Number0009613350-2024-00100
Device Sequence Number1
Product Code LZO
UDI-Device Identifier00889024430365
UDI-Public(01)00889024430365(17)320425(10)3111715
Combination Product (y/n)N
Reporter Country CodeAS
PMA/PMN Number
K192416
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 04/10/2024
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 Lay User/Patient
Device Model NumberN/A
Device Catalogue Number00877503602
Device Lot Number3111715
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 03/02/2024
Initial Date FDA Received03/19/2024
Supplement Dates Manufacturer Received04/09/2024
Supplement Dates FDA Received04/10/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured04/22/2022
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) Hospitalization; Required Intervention;
Patient Age77 YR
Patient SexMale
Patient Weight70 KG
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