MAUDE MDR 8239642

MDR report key
8239642
Report number
0001822565-2018-07054
Event key
0
Event type
3
Date of event
2018-12-06
Date received
2019-01-11
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. CHRISTINA ARNT
Address
56 E. BELL DR. WARSAW IN 46582 US
Phone
574-574-5745
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
136MM VIT E LINER +6MMPROSTHESIS, SHOULDERZIMMER BIOMET, INC.PAON/A0043500360663334004R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-01-110

Event Narratives#

N

Patient 1

(B)(4). MULTIPLE MDR'S WERE FILED FOR THIS EVENT. PLEASE SEE ASSOCIATED REPORT(S): 0001822565 - 2018 - 07055. (B)(4). THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. DEVICE REMAINS IMPLANTED.

D

Patient 1

IT WAS REPORTED THAT DURING A REVERSE TOTAL SHOULDER ARTHROPLASTY, THE POLY FAILED TO SEAT FULLY AND A SMALL PIECE OF POLY WAS SHAVED OFF THE LINER ATTEMPTING TO GET IT FULLY SEATED. THE PROCEDURE WAS ABLE TO BE SUCCESSFULLY COMPLETED. THERE WERE NO PATIENT CONSEQUENCES AS A RESULT OF THE MALFUNCTION. NO FURTHER INFORMATION AVAILABLE AT THIS TIME.

N

Patient 1

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. DHR WAS REVIEWED AND NO DISCREPANCIES WERE FOUND. 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.

D

Patient 1

NO FURTHER INFORMATION AVAILABLE AT THIS TIME.