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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 11X142MM 2MM T1; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 11X142MM 2MM T1; PROSTHESIS, HIP Back to Search Results
Model Number N/A
Device Problems Failure to Osseointegrate (1863); Loosening of Implant Not Related to Bone-Ingrowth (4002)
Patient Problems Failure of Implant (1924); Pain (1994); Ambulation Difficulties (2544); Inadequate Osseointegration (2646)
Event Date 02/07/2022
Event Type  Injury  
Event Description
It was reported the patient underwent left total hip arthroplasty.Subsequently, the patient underwent a revision approximately 2 years later due to aseptic loosening of the femoral stem, pain and difficulty ambulating.During the revision, a lack of in-growth on the femoral stem was noted.The stem, head, and liner were replaced without complication.Attempts have been made and additional information on the reported event is unavailable at this time.
 
Manufacturer Narrative
(b)(4).Concomitant medical products: ref (b)(4), lot 6601603, g7 shell; ref (b)(4), lot 64495274, screw; ref (b)(4), lot 64563153, screw; ref (b)(4), lot 948540, dm liner; ref (b)(4), lot 560940, dm bearing; ref (b)(4), lot 2983045, biolox head; ref (b)(4), lot 6551317, taperloc stem.The device will not be returned for analysis, as the device was discarded; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental medwatch 3500a will be submitted.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.No product was returned or pictures provided; visual and dimensional evaluations could not be performed.Medical records/radiographs were provided and reviewed by a health care professional.A review of the available records identified findings of the reported issues contralateral hip performed, increase in pain with ambulation, x-ray shows radiolucency around stem, no ingrowth was noted.A review of the device history records identified no related deviations or anomalies during manufacturing.A definitive root cause cannot be determined.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
No further event information available at the time of this report.
 
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Brand Name
TPRLC 133 T1 PPS HO 11X142MM 2MM T1
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 Key13758646
MDR Text Key287251265
Report Number0001825034-2022-00407
Device Sequence Number1
Product Code KWL
UDI-Device Identifier00880304489714
UDI-Public(01)00880304489714(17)290624(10)6551317
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K200196
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Distributor
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 04/12/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/14/2022
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue Number51-104110
Device Lot Number6551317
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received04/11/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured08/30/2019
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 SexFemale
Patient Weight64 KG
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