FDA Adverse Event Malfunction Summary report: N

NOVOHIP TOTAL HIP SYSTEM

MDR report key: 20412105 · Received October 9, 2024

Report

Report Number
3014273644-2024-00002
Event Type
Malfunction
Date Received
October 9, 2024
Report Date
September 12, 2024
Manufacturer
NOVOSOURCE, LLC
Product Code
LPH
UDI-DI
00811382037818
PMA / PMN Number
K132158
Removal / Correction Number
3014273644/09232024/C/00
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Description of Event or Problem · 0

AN INITIAL COMPLAINT WAS RECEIVED ON SEPTEMBER 12, 2024, INDICATING THAT IT WAS DISCOVERED INTRAOPERATIVELY THAT A BOX LABELED AS CONTAINING A SIZE 28 L CERAMIC HEAD ACTUALLY CONTAINED A SIZE 32 L CERAMIC HEAD (CORRECT SIZE DIRECTLY MARKED ON THE DEVICE). NO PATIENT INJURY OR DEATH WAS REPORTED. NOVOSOURCE BECAME AWARE THAT BIOLOX CERAMIC HEADS, A COMPONENT IN THE NOVOSOURCE TOTAL HIP SYSTEM HAD BEEN MISLABELED. SIZES 28 L AND 32 L HAD SEEMINGLY BEEN REVERSED. THE PRELIMINARY INVESTIGATION INDICATED THAT THE ISSUE WAS RESTRICTED TO 2 LOTS, EACH CONTAINING A QUANTITY OF 10 UNITS. AS PART OF THE ONGOING COMPLAINT INVESTIGATION AND CONTAINMENT ACTIONS, THE SUSPECT LOT AND THE ASSOCIATED LOT (PACKAGING LABELED AS SIZE 32 L HEADS) WERE REQUESTED TO BE RETURNED FOR EVALUATION. UPON INSPECTION OF THE RETURNED UNITS, NOVOSOURCE IS AWARE THAT THE 28 L CERAMIC HEADS WERE INDEED ALSO PACKAGED WITH LABELING THAT INDICATED SIZE 32 L. THUS, THE DECISION WAS BEEN MADE THAT A FIRM-INITIATED RECALL WAS APPROPRIATE AND THE APPROPRIATE FDA DIVISION RECALL COORDINATOR WAS NOTIFIED WITHOUT DELAY. FINALLY, INFORMATION OBTAINED THROUGH A HEALTH HAZARD EVALUATION SUPPORTED THAT IF THE MALFUNCTION WERE TO RECUR, IT WOULD LIKELY CAUSE OR CONTRIBUTE TO SERIOUS INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1737287 NOVOHIP TOTAL HIP SYSTEM HIP PROSTHESIS LPH NOVOSOURCE, LLC 1345-2803 CER0021 00811382037818

Patients

Seq Age Sex Outcome Treatment
1 77 YR Male