MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,other report with the FDA on 2020-03-24 for FEMORAL STEM 12/14 NECK TAPER N/A 00771101020 manufactured by Zimmer Biomet, Inc..
[186102989]
(b)(4). Concomitant medical products: 00801803203? Cocr head? 61377636, 536000057? Shell? 61352128, 437632057? Durasul liner - 6091b317. Customer has indicated that the product will not be returned to zimmer biomet for the investigation as the device remain implanted. 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: 0002648920 - 2020 - 00191.
Patient Sequence No: 1, Text Type: N, H10
[186102990]
It was reported that patient is experiencing elevated metal ion levels, chronic toxic encephalopathy, left lateral hip pain, neuropathy, fatigue, tremors, synovitis, capsular thickening and cardiac complications after an unknown amount of time post implantations. No revision surgery has been reported to date. Attempts have been made and additional information on the reported event is unavailable at this time.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 0001822565-2020-01041 |
| MDR Report Key | 9872066 |
| Report Source | HEALTH PROFESSIONAL,OTHER |
| Date Received | 2020-03-24 |
| Date of Report | 2020-03-23 |
| Date Mfgr Received | 2020-03-02 |
| Device Manufacturer Date | 2009-12-21 |
| Date Added to Maude | 2020-03-24 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. CHRISTINA ARNT |
| Manufacturer Street | 56 E. BELL DR. |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal | 46582 |
| Manufacturer Phone | 5745273773 |
| Manufacturer G1 | ZIMMER BIOMET, INC. |
| Manufacturer Street | 56 E. BELL DRIVE |
| Manufacturer City | WARSAW IN 46582 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 46582 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | N/A |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | FEMORAL STEM 12/14 NECK TAPER |
| Generic Name | PROSTHESIS, HIP |
| Product Code | LZO |
| Date Received | 2020-03-24 |
| Model Number | N/A |
| Catalog Number | 00771101020 |
| Lot Number | 61375621 |
| Device Expiration Date | 2019-12-31 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ZIMMER BIOMET, INC. |
| Manufacturer Address | 56 E. BELL DRIVE WARSAW IN 46582 US 46582 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2020-03-24 |