FDA Adverse Event Injury Summary report: N

PINNACLE SECTOR II CUP 56MM

MDR report key: 11968630 · Received June 9, 2021

Report

Report Number
1818910-2021-12254
Event Type
Injury
Date Received
June 9, 2021
Date of Event
May 24, 2021
Report Date
May 24, 2021
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
LPH
UDI-DI
10603295009849
PMA / PMN Number
P070026
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT #: (B)(4). INVESTIGATION SUMMARY: NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. THE INFORMATION RECEIVED WILL BE RETAINED FOR POTENTIAL SERIES INVESTIGATIONS IF TRIGGERED BY TREND ANALYSIS, POST MARKET SURVEILLANCE, OR OTHER EVENTS WITHIN THE QUALITY SYSTEM. DEPUY CONSIDERS THE INVESTIGATION CLOSED. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION WILL BE RE-OPENED AS NECESSARY. DEVICE HISTORY LOT: THE PRODUCT INVESTIGATION FOUND NO EVIDENCE SUSPECTING AN ERROR IN THE MANUFACTURING OR MATERIAL THAT WOULD BE A CONTRIBUTING FACTOR IN THE REPORTED ALLEGATION(S). A MANUFACTURING RECORDS EVALUATION (MRE) WAS NOT PERFORMED.

Additional Manufacturer Narrative · 1

(B)(4). IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAD HIS REPLACED 14 YEARS AGO BY ANOTHER SURGEON AT ANOTHER HOSPITAL WHICH WAS NOT KNOWN AT THE TIME I ASKED DURING SURGERY. THIS PATIENT DID WELL UNTIL RECENTLY WHERE HE CAME IN TO SEE THE SURGEON. THE X-RAYS INDICATED THE FEMORAL HEAD WAS ARTICULATING ON THE CUP. THE SURGEON AND THE PATIENT DECIDED THAT A REVISION WOULD BE DONE TO CORRECT THE ISSUE. DURING THE SURGERY THE 56MM ACETABULAR SECTOR CUP, 56MM MARATHON LINER, AND A 36MM 8.5 HIP BALL WERE EXPLANTED. THE AML STEM, LOTT AND CAT # UNKNOWN WAS LEFT IN VITRO. THE ACETABULAR LINER WAS BROKEN AND THE HIP BALL WAS RUBBING AGAINST THE ACETABULAR CUP WHICH CAUSED SIGNIFICANT DAMAGE TO THE FEMORAL HEAD AND LINER. A NEW COMPETITOR CUP WAS IMPLANTED. DOI: 14 YEARS AGO, DOR: (B)(6) 2021; (LEFT HIP).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
866606 PINNACLE SECTOR II CUP 56MM PINNACLE HIP SYSTEM : HIP METAL ACETABULAR CUPS LPH DEPUY ORTHOPAEDICS INC US 1217-22-056 10603295009849

Patients

Seq Age Sex Outcome Treatment
1 81 YR Required Intervention DELTA CER HEAD 12/14 36MM +8.5| PINN MAR +4 10D 36IDX56OD| PINNACLE SECTOR II CUP 56MM| UNKNOWN HIP FEMORAL STEM