FDA Adverse Event Injury Summary report: N

ASR ACETABULAR CUPS 52

MDR report key: 2060520 · Received April 6, 2011

Report

Report Number
1818910-2011-05986
Event Type
Injury
Date Received
April 6, 2011
Report Date
March 7, 2011
Manufacturer
DEPUY INTERNATIONAL, LTD.
Product Code
KWA
PMA / PMN Number
K040627
Removal / Correction Number
Z-1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

Additional Manufacturer Narrative · 1

THE ASR PLATFORM WAS VOLUNTARILY RECALLED FROM THE MARKET IN AUGUST 2010, AND THE ASR PRODUCT CODES ARE NOW CONSIDERED INACTIVE. FURTHER INVESTIGATION OF THIS INDIVIDUAL INCIDENT WILL NOT BE UNDERTAKEN, AS THERE IS AN ONGOING INVESTIGATION REGARDING THE ROOT CAUSE(S) AND/OR CORRECTIVE ACTIONS. (B)(4). DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Description of Event or Problem · 1

BILATERAL PATIENT. LITIGATION PAPERS ALLEGE PT INITIALLY DID WELL AFTER THE HIP REPLACEMENT SURGERIES, MAKING REASONABLE PROGRESS IN PHYSICAL THERAPY AND RECOVERY. HOWEVER, IN 2010, PT BEGAN IN HAVING PAIN AND PROBLEMS IN HER RIGHT AND LEFT HIP AREAS. THROUGHOUT THE NEXT SEVERAL MONTHS, PATIENT'S PAIN IN HER RIGHT AND LEFT HIPS CONTINUED TO INCREASE. PT ALSO BEGAN EXPERIENCING OTHER PROBLEMS, INCLUDING DIFFICULTY WALKING, AND A "CATCH" IN HER RIGHT AND LEFT HIPS. THE PT ALSO UNDERWENT BLOOD TESTS WHICH DETERMINED SHE HAS HIGHER THAN NORMAL LEVELS OF METAL IONS IN HER BLOOD DUE TO A BREAKDOWN OF THE DEVICE'S METAL COMPONENTS. IT IS FURTHER ALLEGED THE PT WILL BE REQUIRED TO UNDERGO TESTING TO DETERMINE IF HE (SIC) HAS METAL DEBRIS OR PARTICLES IN HIS (SIC) BODY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ASR ACETABULAR CUPS 52 PROSTHESIS, HIP, SEMI-CONSTRAINED (METAL UNCEMENTED ACETABULAR COMPONENT) KWA DEPUY INTERNATIONAL, LTD. NA 2613364

Patients

Seq Age Sex Outcome Treatment
1 NA Required Intervention