MAUDE Adverse Event Report: ZIMMER BIOMET, INC. ARCOS 15X250MM INTLKNG DIST; PROSTHESIS, HIP

Model Number N/A

Device Problem Difficult or Delayed Positioning (1157)

Patient Problem No Code Available (3191)

Event Date 06/28/2019

Event Type  Injury  

Manufacturer Narrative

(b)(4).Report source: (b)(6).Customer has indicated that the product will not be returned to zimmer biomet for investigation.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.Multiple mdr reports were filed for this event, please see associated reports: 0001825034 - 2019 - 03090.

Event Description

It was reported that arcos interlocking stem was used and secured with screw.Proximal cone body prepared for and then trialed on the stem.Cone body got stuck on the stem.The staff was unable to remove it and had to remove interlocking stem and replace with a larger one.There was a delay of 60 min.Attempts have been made and additional information on the reported event is unavailable at this time.

Event Description

No further event information available at the time of this report.

Manufacturer Narrative

Udi# (b)(4).Reported event was unable to be confirmed due to limited information received from the customer.Review of the device history record for the distal stem identified no deviations or anomalies would contribute to reported event.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.

• Brand Name: ARCOS 15X250MM INTLKNG DIST
• Type of Device: PROSTHESIS, HIP
• Manufacturer (Section D): ZIMMER BIOMET, INC.; 56 e. bell drive; warsaw IN 46582
• MDR Report Key: 8817738
• MDR Text Key: 151925519
• Report Number: 0001825034-2019-03089
• Device Sequence Number: 1
• Product Code: KWY
• Combination Product (y/n): N
• PMA/PMN Number: K100469
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,foreig
• Type of Report: Initial,Followup
• Report Date: 08/26/2019

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 07/23/2019
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Model Number: N/A
• Device Catalogue Number: 11-301915
• Device Lot Number: 084370
• Was Device Available for Evaluation?: No
• Was the Report Sent to FDA?: No
• Date Manufacturer Received: 08/21/2019
• Is This a Reprocessed and Reused Single-Use Device?: No
• Removal/Correction Number: N/A
• Patient Sequence Number: 1
• Treatment: UNKNOWN ARCOS CONE BODY; ZIMMER SCREW CAT#47248303050 LOT#63733805; UNKNOWN ARCOS CONE BODY; ZIMMER SCREW CAT#47248303050 LOT#63733805
• Patient Outcome(s): Other