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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER GMBH BIOLOX DELTA, CERAMIC FEMORAL HEAD, M 32/0, TAPER 12/14; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER, CEMENTED OR NON-POROUS

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ZIMMER GMBH BIOLOX DELTA, CERAMIC FEMORAL HEAD, M 32/0, TAPER 12/14; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER, CEMENTED OR NON-POROUS Back to Search Results
Model Number N/A
Device Problem Device Slipped (1584)
Patient Problems Pain (1994); Scar Tissue (2060)
Event Date 01/09/2014
Event Type  Injury  
Manufacturer Narrative
The manufacturer did not receive devices, x-rays, or other source documents for review as the patient has not been revised.Where lot numbers were received for the devices, the device history records were reviewed and found to be conforming.A cause for this specific event cannot be ascertained from the information provided.Should additional information become available and an investigation result be available, that changes this assessment, an amended medical device report will be submitted.This is a split complaint with zimmer inc.(b)(4) reported on (b)(4).Zimmer¿s reference number of this file is (b)(4).
 
Event Description
It was reported that the patient was implanted a biolox delta, ceramic femoral head, m, 32/0, taper 12/14 on (b)(6) 2013.The patient underwent a procedure to remove scar tissue and adhesions approximately four months post implantation after experiencing pain, slippage and instability.No devices were removed.
 
Manufacturer Narrative
As soon as additional information become available and/or an investigation result be available, an amended medical device report will be submitted.Zimmer's reference number of this file is cmp(b)(4).
 
Event Description
It was further reported that the biolox delta, ceramic femoral head was revised due to pain and instability on (b)(6) 2014.
 
Manufacturer Narrative
No trend considering the following event is identified: instability.Device history records (dhr): the device manufacturing quality records indicate that the released components met all requirements to perform as intended.Event summary: it was reported that patient underwent total hip procedure on (b)(6) 2013 and experienced pain, slippage and instability due to scar tissue and adhesions.The first surgery was (b)(6), 2014 and removed scar tissue, no devices were removed.- no medical data such as x-rays, surgical notes or any other case-relevant documents received.- no product was returned to zimmer biomet for in-depth analysis as the device was not explanted.- the compatibility check was performed from (b)(6) and showed that the product combination was approved by zimmer biomet.Root cause analysis root cause determination using dfmea(biolox head): - mal-function of tha (wear, fracture, dislocation etc.) due to wrong size of head diameter and/or offset, wrong taper size combination not possible: correct combination was done.- mal-function of tha (wear, fracture, dislocation etc.) due to off label use, combination with competitor products not possible: the used components are from zimmer biomet.- loss of connection due to inadequate assembling procedure possible: no surgical report was provided.It is unknown which steps were done in the surgery.Conclusion summary it was reported that patient underwent total hip procedure on (b)(6) 2013 and experienced pain, slippage and instability due to scar tissue and adhesions.The first surgery was (b)(6), 2014 and removed scar tissue, no devices were removed.As no devices were removed, no devices were available for the investigation.Therefore the condition of the components is unknown.Neither x-rays, operative notes nor office visit notes were received.Based on the given information and the results of the investigation, the complaint could not be confirmed as the alleged failure could not be identified or reproduced.The need for corrective measures is not indicated and zimmer (b)(4) considers this case as closed.Zimmer¿s reference number of this file is (b)(4).
 
Event Description
It was yet reported, that during the surgery of (b)(6), 2014, scar tissue was removed only.No devices were removed.
 
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Brand Name
BIOLOX DELTA, CERAMIC FEMORAL HEAD, M 32/0, TAPER 12/14
Type of Device
PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER, CEMENTED OR NON-POROUS
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 Key6543309
MDR Text Key74357021
Report Number0009613350-2017-00612
Device Sequence Number1
Product Code LZO
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type consumer
Reporter Occupation Patient
Type of Report Initial,Followup,Followup
Report Date 05/04/2017
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? Yes
Device Operator Lay User/Patient
Device Expiration Date04/30/2023
Device Model NumberN/A
Device Catalogue Number00-8775-032-02
Device Lot Number2697053
Other Device ID Number00889024430327
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 04/06/2017
Initial Date FDA Received05/04/2017
Supplement Dates Manufacturer ReceivedNot provided
09/12/2017
Supplement Dates FDA Received05/23/2017
10/03/2017
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured05/23/2013
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 Age58 YR
Patient Weight89
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