FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY ASR HIP

MDR report key: 2231845 · Received September 1, 2011

Report

Report Number
1818910-2011-17018
Event Type
Injury
Date Received
September 1, 2011
Report Date
August 3, 2011
Manufacturer
DEPUY INTERNATIONAL
Product Code
KWA
Removal / Correction Number
Z-1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MS, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE ASR PLATFORM WAS VOLUNTARILY RECALLED FROM THE MARKET IN (B)(4) 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

LITIGATION PAPERS ALLEGE: BILATERAL PATIENT WAS IMPLANTED WITH A DEPUY ASR HIP IMPLANT ON HIS RIGHT SIDE ON (B)(6) 2008, AND ON HIS LEFT SIDE ON (B)(6) 2008. AFTER THE SURGERIES, PATIENT EXPERIENCED SEVERE PAIN AND DISCOMFORT, EXPRESSED SYMPTOMS INDICATING A LOOSE IMPLANT, AND WILL ULTIMATELY UNDERGO REVISION SURGERY. HE HAS ALSO SUFFERED LOSS OF MUSCLE MASS, LOSS OF SLEEP, HAS DIFFICULTY MAINTAINING HIS BALANCE, AND WALKS WITH A LIMP. IN ADDITION, BLOOD RESULTS INDICATE HE HAS ELEVATED LEVELS OF COBALT AND CHROMIUM IN HIS BLOOD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN DEPUY ASR HIP TOTAL HIP REPLACEMENT KWA DEPUY INTERNATIONAL NI

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention