BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TORNIER PYROCARBON HUM HEAD DIA 46MMX17MMX4.0MM ECC

    MDR report key: 17600395 · Received August 22, 2023

    Report

    Report Number
    3000931034-2023-00263
    Event Type
    Injury
    Date Received
    August 22, 2023
    Date of Event
    April 13, 2022
    Report Date
    August 22, 2023
    Manufacturer
    TORNIER S.A.S.
    Product Code
    QKW
    UDI-DI
    03700434021318
    PMA / PMN Number
    DEN220012
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    PHYSICIAN
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    THE REPORTED EVENT COULD NOT BE CONFIRMED, SINCE THE DEVICE WAS NOT RETURNED FOR EVALUATION AND NO OTHER EVIDENCES WERE PROVIDED. THE DEVICE INSPECTION WAS NOT POSSIBLE AS THE PRODUCT WAS NOT RETURNED FOR INVESTIGATION. A REVIEW OF THE DEVICE HISTORY WAS NOT NECESSARY BECAUSE THE IMPLANT AFFECTED BY THIS COMPLAINT HAS BEEN MANUFACTURED PRIOR TO 2018. AS A RESULT, THIS IMPLANT IS EXPIRED AND CAN NO LONGER BE PUT ON THE MARKET OR IMPLANTED. THE COMPLAINT HISTORY REVIEW FOUND NO OTHER COMPLAINT RECORDED FOR THIS LOT NUMBER. MOREOVER, THE POST MARKET SURVEILLANCE REVIEWS HAVE NOT IDENTIFIED ANY SIGNALS FOR SIMILAR ISSUES THAT WOULD HAVE CHALLENGED THE EFFICACY AND SAFETY OF THIS PRODUCT. A REVIEW OF THE LABELING DID NOT INDICATE ANY ABNORMALITIES. THE NATURE OF THE COMPLAINT DOESN¿T NECESSITATE A DRAWING REVIEW. MORE DETAILED INFORMATION ABOUT THE COMPLAINT EVENT AS WELL AS THE AFFECTED DEVICE MUST BE AVAILABLE IN ORDER TO DETERMINE THE ROOT CAUSE OF THE COMPLAINT EVENT. IF DEVICE IS RETURNED OR ANY FURTHER INFORMATION IS PROVIDED, THE INVESTIGATION REPORT WILL BE REASSESSED. H3 OTHER TEXT : DEVICE NOT AVAILABLE

    Description of Event or Problem · 0

    THE MANUFACTURER RECEIVED A REPORT FROM THE NATIONAL JOINT REGISTRY THAT CONTAINS UNPUBLISHED COLLECTED DATA ON THE USAGE AND THE OUTCOMES WITH THE TORNIER SHOULDER SYSTEM. THE REPORT DETAILS ANALYSIS PROVIDED FOR PROCEDURES PERFORMED BETWEEN APRIL 2012 ¿ MAY 2022. DURING THE REVIEW OF THE REPORT, IT WAS IDENTIFIED THAT ON (B)(6) 2022 A PATIENT REQUIRED REVISION SURGERY DUE STIFFNESS AND UNEXPLAINED PAIN, EVENT WAS NOT PREVIOUSLY REPORTED TO THE MANUFACTURER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1405367 TORNIER PYROCARBON HUM HEAD DIA 46MMX17MMX4.0MM ECC SHOULDER JOINT HUMERAL (HEMI-SHOULDER) CERAMIC HEAD/METALLIC STEM CEMENTED QKW TORNIER S.A.S. 3427AT 03700434021318

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Male Required Intervention