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Zimmer biomet complaint (b)(4).D10 ¿ medical products: item #24-6561i, lot # 013210b; tmj system med left fossa component item # tmjpm-2397, lot #968200a; custom right pm-tmj & model g2: foreign: france.No product was returned, or pictures provided; visual and dimensional evaluations could not be performed.Review of the device history record(s) identified no deviations or anomalies during manufacturing related to the reported event.Medical records/radiographs were provided and reviewed by the designer, 3d systems.Review of the available records identified the following: left joint overlay: the tmj components on the patient¿s left side are positioned differently from what was planned.This may have affected the patient¿s occlusion and the position of the components on the patient¿s right side.The fossa component is approximately 4.5mm more posterior than what was planned.The component is also rotated away from frankfurt horizontal.The mandible component is approximately 5mm more posterior than what was planned.The component is also misaligned from the center of the fossa cup.The left fossa post-op appears as though the most posterior fossa screw on the left side may be intruding into the patient¿s brain cavity.The right joint overlay: the tmj components on the patient¿s right side are positioned differently from what was planned.This may have affected the patient¿s occlusion and the position of the components on the patient¿s left side.The fossa component is approximately 2mm more anterior than what was planned.The component is also rotated away from frankfurt horizontal.The root cause of the reported issue is attributed implants not placed in planned position.The design of the device was reviewed by the designer, 3d systems: three years after implementation of the tmjpm, the patient was complaining of pain on their left side.Overlays of pre- and post-operative scans revealed the tmj protheses are not in the planned position.The overlay report shows that the patient¿s occlusion is not in the planned position, and a screw minimally penetrates the patient's brain cavity, which was caused by misplacement of the fossa implant.Review of the case shows that all parts were properly designed, and, in the proper position the screws posed no risk of penetrating the brain cavity.The reported event is confirmed.A summary of the investigation was sent to the surgeon.If any further information is found which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.Multiple mdr reports were filed for this event, please see associated reports: 0001032347-2023-00200 and 0001032347-2023-00350.
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