BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ACETABULAR CUP HAP SIZE 52/58

    MDR report key: 10418553 · Received August 17, 2020

    Report

    Report Number
    3005975929-2020-00298
    Event Type
    Injury
    Date Received
    August 17, 2020
    Date of Event
    November 4, 2019
    Report Date
    September 18, 2023
    Manufacturer
    SMITH & NEPHEW ORTHOPAEDICS LTD
    Product Code
    NXT
    UDI-DI
    03596010552310
    PMA / PMN Number
    P040033
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    OTHER
    Health Professional
    N

    Narratives

    Additional Manufacturer Narrative · 0

    IT WAS REPORTED THAT RIGHT HIP REVISION SURGERY WAS PERFORMED. THE DEVICES INVOLVED WERE ALL USED IN TREATMENT. AS OF TODAY, ADDITIONAL INFORMATION HAS BEEN REQUESTED FOR THIS COMPLAINT BUT HAVE NOT BECOME AVAILABLE. WITHOUT DEFINITIVE PART AND LOT NUMBERS A COMPLAINT HISTORY, DHR REVIEW AND DEVICE LABELLING CANNOT BE PERFORMED FOR THE DEVICES INVOLVED. SHOULD THE LOT/BATCH/SERIAL NUMBER BECOME AVAILABLE AT A LATER DATE THEN THE COMPLAINT HISTORY TASK, DHR AND DEVICE LABELLING WILL BE RE-OPENED AND COMPLETED. A RISK MANAGEMENT REVIEW WAS PERFORMED. NO ADDITIONAL RISKS WERE IDENTIFIED AS RESULT OF THE REPORTED EVENT. NO FURTHER ACTIONS ARE REQUIRED AT THIS TIME. WITHOUT RETURN OF THE ACTUAL DEVICES OR FURTHER INFORMATION WE CANNOT FURTHER INVESTIGATE OR CONFIRM THE DETAILS SUPPLIED IN THIS COMPLAINT, AND OUR INVESTIGATION REMAINS INCONCLUSIVE. IF THE PRODUCTS OR ADDITIONAL INFORMATION BECOME AVAILABLE IN THE FUTURE, THIS CASE WILL BE REOPENED. NO PREVENTATIVE OR CORRECTIVE ACTION HAS BEEN INITIATED AS A RESULT OF THIS INVESTIGATION.

    Additional Manufacturer Narrative · 0

    H10: ADDITIONAL INFORMATION. A1: PATIENT IDENTIFIER. A2: AGE AT THE TIME OF EVENT. A4: PATIENT WEIGHT. B7: OTHER RELEVANT HISTORY, INCLUDING PREEXISTING MEDICAL CONDITIONS. D4: EXPIRATION DATE. D10: CONCOMITANT MEDICAL PRODUCTS. G1: PHONE NUMBER. G4: PMA/510(K) NUMBER. H4: DEVICE MANUFACTURE DATE H11- CORRECTED DATA. B1: ADVERSE EVENT AND PRODUCT PROBLEM. B3: DATE OF EVENT. B5: DESCRIBE EVENT OR PROBLEM. B6: RELEVANT TESTS. D1: BRAND NAME. D4: CATALOG NUMBER, LOT NUMBER, SERIAL NUMBER ¿ PLEASE NOTE THAT SERIAL NUMBER IS NOT APPLIABLE FOR THIS DEVICE, FOR WHICH THIS SPACE IS INTENDED TO BE LEFT IN BLANK. D6B: EXPLANTED DATE. E1: INITIAL REPORTER NAME. G: CONTACT OFFICE. G2: REPORT SOURCE. H6: EVALUATION CODES.

    Additional Manufacturer Narrative · 0

    ADDITIONAL INFORMATION: A3. H3, H6: IT WAS REPORTED THAT, AFTER UNDERGOING RIGHT HIP RESURFACING (BHR), THE PATIENT SUFFERED METALLOSIS ALONG WITH IMPLANT MECHANICAL FAILURE. THE PATIENT PRESENTED METAL-STAINED FIBROTIC TISSUE AND PSEUDOTUMOR. THESE COMPLICATIONS WERE TREATED BY PERFORMING A REVISION SURGERY, IN WHICH BOTH BHR COMPONENTS WERE EXPLANTED AND REPLACED WITH A COMPETITOR¿S TOTAL HIP ARTHROPLASTY SYSTEM. THE PATIENT LEFT THE OPERATING ROOM IN STABLE CONDITION. AS OF TODAY, THE IMPLANTED DEVICES, ALL OF WHICH WERE USED IN TREATMENT HAVE NOT BEEN RETURNED FOR EVALUATION. A REVIEW OF THE HISTORICAL COMPLAINTS DATA FOR THE DEVICES CONCERNED WAS PERFORMED USING BATCH NUMBERS, PART NUMBERS AND THE REPORTED FAILURE MODES TO EVALUATE PATTERNS OF REPEATED FAILURES OR DEFECTS. SIMILAR COMPLAINTS HAVE BEEN IDENTIFIED FOR THE BHR CUP, AND THIS FAILURE WILL CONTINUE TO BE MONITORED. IN THE ABSENCE OF THE ACTUAL DEVICES, THE PRODUCTION RECORDS WERE REVIEWED FOR THE DEVICES REPORTEDLY INVOLVED IN THIS INCIDENT. ALL RELEASED DEVICES INVOLVED MET MANUFACTURING SPECIFICATIONS UPON RELEASE FOR DISTRIBUTION. THE REVIEW OF THE PRODUCT IFU FOUND ADEQUATE WARNINGS AND PRECAUTIONS IN RELATION TO THE ALLEGED FAILURE MODES. A RISK MANAGEMENT REVIEW WAS PERFORMED. THE ALLEGED FAILURE MODES AND ASSOCIATED RISKS HAVE BEEN ANTICIPATED WITHIN THE RISK FILE AND THE ANTICIPATED RISK LEVEL IS STILL ADEQUATE. NO FURTHER ACTIONS ARE REQUIRED AT THIS TIME. A REVIEW OF HISTORIC ESCALATION ACTIONS RELATED TO THE PRODUCTS AND SIMILAR COMPLAINT EVENTS WAS PERFORMED. FOLLOWING THE REVIEW, NO PRIOR APPLICABLE ESCALATION ACTIONS WERE IDENTIFIED. THE AVAILABLE MEDICAL DOCUMENTS WERE REVIEWED. WITH THE INFORMATION PROVIDED THE CLINICAL ROOT CAUSE OF THE REPORTED ¿METALLOSIS¿ CANNOT BE DEFINITIVELY CONCLUDED. IT CANNOT BE CONCLUDED THE REPORTED ¿METALLOSIS¿ WAS ASSOCIATED WITH A MAL PERFORMANCE OF THE IMPLANT OR IMPLANT FAILURE. THE PATIENT IMPACT BEYOND THE REVISION AND POST OPERATIVE CONVALESCENCE CANNOT BE DETERMINED. BASED ON THE INFORMATION PROVIDED, FURTHER INVESTIGATION OF THE REPORTED COMPLAINT CANNOT BE CARRIED OUT AND REMAINS INCONCLUSIVE. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. SPECIFIC FACTORS KNOWN TO CONTRIBUTE TO THE ALLEGED FAULT ARE EXCESSIVE PHYSICAL ACTIVITY LEVELS, UNREASONABLE STRESS ON REPLACEMENT SYSTEM, EXCESSIVE PATIENT WEIGHT, TRAUMA TO THE JOINT REPLACEMENT, LOOSENING OF COMPONENTS MAY INCREASE PRODUCTION OF WEAR PARTICLES AND ACCELERATE DAMAGE TO THE BONE. SHOULD THE DEVICES OR ADDITIONAL INFORMATION BE RECEIVED, THE COMPLAINT WILL BE REOPENED. BASED ON THIS INVESTIGATION, THE NEED FOR CORRECTIVE AND PREVENTATIVE ACTIONS IS NOT INDICATED.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT, AFTER UNDERGOING RIGHT HIP RESURFACING (BHR), THE PATIENT SUFFERED METALLOSIS ALONG WITH IMPLANT MECHANICAL FAILURE. THE PATIENT PRESENTED METAL-STAINED FIBROTIC TISSUE AND PSEUDOTUMOR. THESE COMPLICATIONS WERE TREATED BY PERFORMING A REVISION SURGERY ON (B)(6) 2019, IN WHICH BOTH BHR COMPONENTS WERE EXPLANTED AND REPLACED WITH A COMPETITOR¿S THA SYSTEM (ZIMMER-BIOMET). THE PATIENT LEFT THE OPERATING ROOM IN STABLE CONDITION.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A REVISION SURGERY WAS PERFORMED ON THE PATIENT RIGHT HIP DUE TO ELEVATED COBALT & CHROMIUM LEVELS, METAL-STAINED FIBROTIC TISSUE AND PSEUDOTUMOR-LIKE TISSUE. THE PATIENT OUTCOME IS UNKNOWN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    878686 ACETABULAR CUP HAP SIZE 52/58 PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/METAL, RESURFACING NXT SMITH & NEPHEW ORTHOPAEDICS LTD 10FW28116 03596010552310

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Male Hospitalization| R BHR RSRF FMRL HD 52MM(PN:74123152,LN:10CW25879).