FDA Adverse Event Injury Summary report: N

ECLIPSE TRUNION 45MM, SLOTTED, TPS CAP

MDR report key: 19894758 · Received August 2, 2024

Report

Report Number
1220246-2024-07010
Event Type
Injury
Date Received
August 2, 2024
Date of Event
July 10, 2024
Report Date
June 18, 2025
Manufacturer
ARTHREX, INC.
Product Code
QHQ
PMA / PMN Number
K183194
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: G3, H3, H6 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.

Additional Manufacturer Narrative · 0

INVESTIGATION IS IN PROCESS. A FOLLOW-UP REPORT WILL BE PROVIDED UPON AVAILABILITY OF ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION RECEIVED ON 11/7/2024: THE PATIENT UNDERWENT REVISION TO AN RSA IMPLANT SYSTEM ON (B)(6) 2024.

Description of Event or Problem · 0

ON 7/10/2024, A CLINDEX NOTIFICATION WAS RECEIVED INDICATING THAT A PATIENT LISTED ON THE SHOULDER ARTHROPLASTY REGISTRY WILL UNDERGO RSA REVISION SURGERY DUE TO A SUBSCAPULARIS FAILURE. ON (B)(6) 2024, THE PATIENT PRESENTED TO THE CLINIC WITH PAIN, AND IT WAS DETERMINED THAT DUE TO SUBSCAPULARIS FAILURE, THE PATIENT WILL UNDERGO REVISION SURGERY TO AN RSA IMPLANT SYSTEM. AN AR-9301-45CPC ARTHREX ECLIPSE TRUNION 45 MM, SLOTTED, TPS CAPWAS, AN AR-9345-17 ARTHREX ECLIPSE HUMERAL HEAD, 45/17, AN AR-9107-01-15R UNIVERS VAULTLOCK AUGMENTED GLENOID, SMALL 15R, AND AN AR-9301-02 ARTHREX ECLIPSE CAGE SCREW MEDIUM (35.0 MM) WERE IMPLANTED IN THE PATIENT ON (B)(6) 2023. THIS EVENT WAS INDICATED AS UNRELATED TO THE ECLIPSE IMPLANT SYSTEM, OR THE STUDY PATIENT WAS PART OF. THE REASON FOR THE SUBSCAPULARIS FAILURE IS UNKNOWN. NO INJURY THAT LED TO FAILURE. THE PATIENT IS STILL EXPERIENCING INSTABILITY, AND THE REVISION SURGERY HAS BEEN SCHEDULED FOR (B)(6) 2024.

Description of Event or Problem · 0

ADDITIONAL INFORMATION RECEIVED ON 11/7/2024: THE PATIENT UNDERWENT REVISION TO AN RSA IMPLANT SYSTEM ON (B)(6) 2024.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
385113 ECLIPSE TRUNION 45MM, SLOTTED, TPS CAP TOT ANAT SHOULDR PROSTH, UNCEM QHQ ARTHREX, INC. ECLIPSE TRUNION 45MM, SLOTTED, TPS CAP UNK

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other