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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. CER OPTION TYPE 1 TPR SLEVE -3; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. CER OPTION TYPE 1 TPR SLEVE -3; PROSTHESIS, HIP Back to Search Results
Model Number N/A
Device Problem Insufficient Information (3190)
Patient Problems Cellulitis (1768); Thrombosis (2100)
Event Date 04/28/2013
Event Type  Injury  
Manufacturer Narrative
(b)(4).Concomitant medical products: 51-104110 tprlc 133 t1 pps ho 11 x 142 mm, 650-1056 cer bioloxd option hd 32 mm, 13-104050 m/h radial solid/apx shl 50 mm, unknown e1 liner.The complaint cannot be confirmed since operative notes or x-rays were not provided from the event.Device history record (dhr) review was unable to be performed as the lot number of the device involved in the event is unknown.Root cause was unable to be determined as the necessary information to adequately investigate the reported event was not provided.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: 0001825034-2018-05602, 0001825034-2018-05603, 0001825034-2018-05604, 0001825034-2018-05605.
 
Event Description
It was reported that approximately 6 months post implantation, the patient was noted to have developed a dvt, and cellulitis to the foot, leg, hip, back, and neck.Attempts have been made and no further information has been provided.
 
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Brand Name
CER OPTION TYPE 1 TPR SLEVE -3
Type of Device
PROSTHESIS, HIP
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
Manufacturer (Section G)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
Manufacturer Contact
christina arnt
56 e. bell dr.
warsaw, IN 46582
5745273773
MDR Report Key7877100
MDR Text Key120283587
Report Number0001825034-2018-08930
Device Sequence Number1
Product Code LZO
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
PK082996
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional,study
Reporter Occupation Physician
Type of Report Initial
Report Date 09/14/2018
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 Number650-1065
Device Lot NumberN/A
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 08/15/2018
Initial Date FDA Received09/14/2018
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) Other;
Patient Age72 YR
Patient Weight79
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