FDA Adverse Event Injury Summary report: N

ECLIPSE TRUNION,39 MM TPS CTD

MDR report key: 11946716 · Received June 7, 2021

Report

Report Number
1220246-2021-03211
Event Type
Injury
Date Received
June 7, 2021
Date of Event
May 17, 2021
Report Date
September 11, 2024
Manufacturer
ARTHREX, INC.
Product Code
QHQ
PMA / PMN Number
K183194
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

BASED ON THE INFORMATION PROVIDED, WHICH MAY INCLUDE THE DEVICE (IF AVAILABLE AND RETURNED), PICTURES, VIDEOS, EVENT DESCRIPTION, AND ANY ADDITIONAL INFORMATION FROM THE FIELD, ARTHREX WAS ABLE TO CONCLUDE A MOST LIKELY CAUSE. THE MOST LIKELY CAUSE FOR THE REPORTED FAILURE CAN BE ATTRIBUTED TO A PATIENT-SPECIFIC EVENT THAT MAY OCCUR DUE TO FATIGUE WEAR OF THE IMPLANT.

Additional Manufacturer Narrative · 0

THE DEVICE WAS NOT RETURNED. AN X-RAY WAS PROVIDED, HOWEVER THE X-RAY DID NOT PROVIDE ENOUGH INFORMATION TO CONFIRM OR INVESTIGATE THE COMPLAINT.

Additional Manufacturer Narrative · 1

THE CONTRIBUTION OF THE DEVICE TO THE REPORTED EVENT COULD NOT BE DETERMINED AS THE DEVICE WAS NOT RETURNED FOR EVALUATION. THE ROOT CAUSE OF THE EVENT COULD NOT BE DETERMINED FROM THE INFORMATION AVAILABLE AND WITHOUT DEVICE EVALUATION. IF THE DEVICE BECOMES AVAILABLE FOR EVALUATION, A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A REVISION SURGERY WAS NECESSARY DUE TO A ASEPTIC LOOSENING OF THE GLENOID. THE SHOULDER PROSTHESIS WAS CHANGED TO AN INVERSE SHOULDER PROSTHESIS. NO FURTHER INFORMATION RECEIVED. 20-MAY-2021 UPDATE DW.: FURTHER INFORMATION WERE PROVIDED THAT THE INITIAL IMPLANTATION WAS PERFORMED ON (B)(6) 2016. DURING THE REVISION IT WAS FOUND THAT THE ROTATOR CUFF WAS INTACT AND THAT THERE WAS NO SIGN OF AN INFECTION OR OTHER MORPHOLOGY OF THE BONE. THE PATIENT HAD A STRAIN ACTIVE LIFE STYLE AND WORK. THE PATIENT WAS TREATED WITH A TORNIER AEQUALIS REVERSED II WITH A GLENOID STRUCTURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
841558 ECLIPSE TRUNION,39 MM TPS CTD TOTAL SHOULDER ARTHROPLASTY SYSTEM QHQ ARTHREX, INC. ECLIPSE TRUNION,39 MM TPS CTD 2501113703

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown