UNKNOWN BI-MENTUM HIP ACETABULAR LINER - INFECTION
Report
- Report Number
- 3008668801-2025-00026
- Event Type
- Injury
- Date Received
- January 23, 2025
- Date of Event
- October 17, 2023
- Report Date
- February 6, 2026
- Manufacturer
- S.E.R.F SOCIETE DETUDES RECHERCHE FABRICATION
- Product Code
- MEH
- PMA / PMN Number
- K181744
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER
- Health Professional
- N
Narratives
IT WAS NOTED THAT THE DEVICE IS NOT AVAILABLE FOR EVALUATION. IF ADDITIONAL INFORMATION IS RECEIVED, IT WILL BE PROVIDED IN A SUPPLEMENTAL REPORT UPON COMPLETION OF THE INVESTIGATION.
REPORTED EVENT: AN EVENT REGARDING INFECTION (LEADING TO REVISION) INVOLVING AN UNKNOWN BI-MENTUM HIP ACETABULAR LINER WAS REPORTED. CONCLUSIONS: THE REPORTED DEVICE IS AN SERF PRODUCT. THE PRODUCTS WERE NOT RETURNED, NO PRODUCT FOR INVESTIGATION CAN BE PERFORMED. NO X RAY HAS BEEN PROVIDED, NO INFORMATION. SERF HAS NO EVIDENCE TO DETERMINE THE CAUSE OF THE COMPLAINT. THESE LISTED EVENTS CANNOT BE INVESTIGATED AND MAY BE CAUSED BY SEVERAL FACTORS THAT CANNOT BE DEMONSTRATED DUE TO LACK OF INFORMATION. THE CAUSE CANNOT BE CONFIRMED.
(B)(4): SERF RC-23-0176" PINNACLE DUAL MOBILITY DATA WAS REVIEWED VIA DATA USE AGREEMENTS WITH MULTIPLE SURGEONS ACROSS MULTIPLE SITES. THE FOLLOWING POST-OPERATIVE ADVERSE EVENTS WERE IDENTIFIED. (B)(6) MEDICAL CENTER 4 INCIDENTS OF CALF SWELLING, INTERVENTION UNKNOWN 2 EMERGENCY DEPARTMENT VISITS, NO FURTHER INFORMATION 4 GROIN PAIN/CATCHING, INTERVENTION UNKNOWN 1 IT BAND TENDONITIS, INTERVENTION UNKNOWN 2 PAIN AT THE INCISION SITE, INTERVENTION UNKNOWN 1 SCIATICA, INTERVENTION UNKNOWN 3 SURGICAL SITE DRAINING, INTERVENTION UNKNOWN. (B)(6) HOSPITAL 1 DEEP PERIPROSTHETIC INFECTION REQUIRING REVISION 1 INTERPROSTHETIC DISLOCATION REQUIRING REVISION 1 LOW BACK AND HIP PAIN, INTERVENTION UNKNOWN INFORMATIONS (B)(6): I AM WORKING ON A PROJECT THAT INVOLVES COLLECTING PINNACLE DUAL MOBILITY DATA VIA DATA USE AGREEMENTS WITH MULTIPLE SURGEONS AT DIFFERENT LOCATIONS. UPON REVIEW OF RECENTLY SUBMITTED DATA, IT WAS NOTED TWENTY-ONE ADVERSE EVENTS AND TWO REVISIONS WERE REPORTED BY TWO SURGEONS ¿ I¿VE INCLUDED THEM IN THE ATTACHED SPREADSHEET. NOTE: THE REPORTED DATA IS SUMMARIZED AND I HAVE NO VISIBILITY TO IMPLANT DETAILS OR ANY PATIENT INFORMATION RELATED TO INDIVIDUAL ADVERSE EVENTS."
(B)(4) "PINNACLE DUAL MOBILITY DATA WAS REVIEWED VIA DATA USE AGREEMENTS WITH MULTIPLE SURGEONS ACROSS MULTIPLE SITES. THE FOLLOWING POST-OPERATIVE ADVERSE EVENTS WERE IDENTIFIED. (B)(6) MEDICAL CENTER 4 INCIDENTS OF CALF SWELLING, INTERVENTION UNKNOWN 2 EMERGENCY DEPARTMENT VISITS, NO FURTHER INFORMATION 4 GROIN PAIN/CATCHING, INTERVENTION UNKNOWN 1 IT BAND TENDONITIS, INTERVENTION UNKNOWN 2 PAIN AT THE INCISION SITE, INTERVENTION UNKNOWN 1 SCIATICA, INTERVENTION UNKNOWN 3 SURGICAL SITE DRAINING, INTERVENTION UNKNOWN. (B)(6) HOSPITAL 1 DEEP PERIPROSTHETIC INFECTION REQUIRING REVISION 1 INTERPROSTHETIC DISLOCATION REQUIRING REVISION 1 LOW BACK AND HIP PAIN, INTERVENTION UNKNOWN INFORMATIONS COMPLÉMENTAIRES DE (B)(6) - STAFF CLINICAL RESEARCH SCIENTIST DEPUY SYNTHES: I AM WORKING ON A PROJECT THAT INVOLVES COLLECTING PINNACLE DUAL MOBILITY DATA VIA DATA USE AGREEMENTS WITH MULTIPLE SURGEONS AT DIFFERENT LOCATIONS. UPON REVIEW OF RECENTLY SUBMITTED DATA, IT WAS NOTED TWENTY-ONE ADVERSE EVENTS AND TWO REVISIONS WERE REPORTED BY TWO SURGEONS ¿ I¿VE INCLUDED THEM IN THE SPREADSHEET. NOTE: THE REPORTED DATA IS SUMMARIZED AND I HAVE NO VISIBILITY TO IMPLANT DETAILS OR ANY PATIENT INFORMATION RELATED TO INDIVIDUAL ADVERSE EVENTS."
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 556218 | UNKNOWN BI-MENTUM HIP ACETABULAR LINER - INFECTION | PROSTHESIS, HIP, SEMI-CONSTRAINED, UNCEMENTED, METAL/POLYMER, NON-POROUS, CALICU | MEH | S.E.R.F SOCIETE DETUDES RECHERCHE FABRICATION | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown | Hospitalization| R |