FDA Adverse Event Malfunction Summary report: N

PINNACLE MTL INS NEUT36IDX54OD

MDR report key: 2241368 · Received September 9, 2011

Report

Report Number
1818910-2011-17390
Event Type
Malfunction
Date Received
September 9, 2011
Report Date
October 18, 2012
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
KWA
PMA / PMN Number
PK003523
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE DEVICES ASSOCIATED WITH THIS REPORT WERE NOT RETURNED. REVIEW OF THE DEVICE HISTORY RECORDS AND/OR A COMPLAINT DATABASE SEARCH WAS NOT POSSIBLE AS THE PRODUCT AND LOT CODES REQUIRED WERE NOT PROVIDED. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS REGARDING THE REPORTED EVENT WITH THE INFORMATION AVAILABLE. BASED ON THE INABILITY TO IDENTIFY A ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT OR ADDITIONAL INFORMATION BE RECEIVED TO CHANGE THE OUTCOME OF THE PERFORMED INVESTIGATION, THE COMPLAINT WILL BE RE-OPENED.

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

UPDATE: (B)(4) 2012 - PFS WAS RECEIVED FROM LEGAL, MEDICAL RECORDS WERE RECEIVED FROM LEGAL, AND PART/LOT INFORMATION WAS IDENTIFIED. RECORDS ARE AVAILABLE FOR FURTHER REVIEW. THE INVESTIGATION IS ONGOING. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

Additional Manufacturer Narrative · 1

NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. BASED ON PREVIOUS INVESTIGATIONS THIS COMPLICATION OF JOINT REPLACEMENT IS UNLIKELY TO HAVE BEEN THE RESULT OF A DEVICE FAILING TO MEET REQUIRED SPECIFICATIONS. THE INFORMATION RECEIVED WILL BE RETAINED FOR POTENTIAL SERIES INVESTIGATIONS IF TRIGGERED BY TREND ANALYSIS, POST MARKET SURVEILLANCE, OR OTHER EVENTS WITHIN THE QUALITY SYSTEM. CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION WILL BE RE-OPENED AS NECESSARY.

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # : (B)(4). NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. A WORLDWIDE LOT SPECIFIC COMPLAINT DATABASE SEARCH, OR DEVICE HISTORY RECORD (DHR) REVIEW WAS NOT POSSIBLE BECAUSE THE REQUIRED LOT CODE(S) WAS NOT PROVIDED. BASED ON PREVIOUS INVESTIGATIONS THIS COMPLICATION OF JOINT REPLACEMENT IS UNLIKELY TO HAVE BEEN THE RESULT OF A DEVICE FAILING TO MEET REQUIRED SPECIFICATIONS. THE INFORMATION RECEIVED WILL BE RETAINED FOR POTENTIAL SERIES INVESTIGATIONS IF TRIGGERED BY TREND ANALYSIS, POST MARKET SURVEILLANCE, OR OTHER EVENTS WITHIN THE QUALITY SYSTEM. CORRECTIVE ACTION WAS NOT INDICATED. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH , A FOLLOW-UP MEDWATCH, WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # (B)(4).

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # (B)(4).

Description of Event or Problem · 1

BILATERAL PATIENT. LITIGATION PAPERS ALLEGE THE FOLLOWING: FOLLOWING HIS IMPLANTATIONS, PATIENT BEGAN EXPERIENCING DEBILITATING PAIN, DISCOMFORT, AND SORENESS IN THE AREA OF BOTH OF HIS HIP IMPLANTS, WHICH IN TURN NEGATIVELY AFFECTED HIS ABILITY TO WALK, MOVE, AND GO UP AND DOWN STAIRS AND REQUIRES PATIENTS USAGE OF A CANE. ON INFORMATION AND BELIEF, FRICTION AND WEAR BETWEEN THE COBALT-CHROMIUM METAL HEAD AND COBALT-CHROMIUM METAL LINER CAUSED TOXIC COBALT-CHROMIUM METAL IONS AND PARTICLES TO BE RELEASED INTO PATIENTS BLOOD, TISSUE AND BONE SURROUNDING THE IMPLANT. PATIENT WILL LIKELY NEED TO UNDERGO REVISION SURGERIES TO REPLACE THE IMPLANTS.

Description of Event or Problem · 1

NEW ETQ RECORD CREATED IN ORDER TO UPDATE ETQ (LEGACY SYSTEM) COMPLAINT NUMBER (B)(4). REASON FOR ORIGINAL COMPLAINT.- BILATERAL PATIENT. LITIGATION PAPERS ALLEGE THE FOLLOWING: FOLLOWING HIS IMPLANTATIONS, PATIENT BEGAN EXPERIENCING DEBILITATING PAIN, DISCOMFORT, AND SORENESS IN THE AREA OF BOTH OF HIS HIP IMPLANTS, WHICH IN TURN NEGATIVELY AFFECTED HIS ABILITY TO WALK, MOVE, AND GO UP AND DOWN STAIRS AND REQUIRES PATIENT'S USAGE OF A CANE. PATIENT WILL LIKELY NEED TO UNDERGO REVISION SURGERIES TO REPLACE THE IMPLANTS. UPDATE: (B)(4) 2012 PFS WAS RECEIVED FROM LEGAL, MEDICAL RECORDS WERE RECEIVED FROM LEGAL, AND PART/LOT INFORMATION WAS IDENTIFIED. RECORDS ARE AVAILABLE FOR FURTHER REVIEW. UPDATE REC'D (B)(4) 2014 - SALES REP REPORTED REVISION SURGERY OF THE LINER FOR THE RIGHT HIP. REASON FOR REVISION NOT PROVIDED. SHOULD WE RECEIVE FURTHER INFORMATION, THE COMPLAINT WILL BE UPDATED AT THAT TIME. THE COMPLAINT WAS UPDATED ON: (B)(4) 2014 UPDATE AD (B)(4) 2018: (B)(4) HAS BEEN RE-OPENED TO PC-000242907 DUE TO RECEIPT OF PPF AND MEDICAL RECORDS. IN ADDITION TO WHAT WAS PREVIOUSLY ALLEGED, PPF ALLEGES PSEUDOTUMOR, METALLOSIS,METAL WEAR, AND ELEVATED METAL IONS. UPDATED PATIENT IDENTIFIER AND DATE OF REVISION. CORRECTED PATIENT HEIGHT. NO LABORATORY RESULTS PROVIDED. DOI: (B)(6) 2008 - DOR:05/14/2012 (LEFT HIP).

Description of Event or Problem · 1

NEW ETQ RECORD CREATED IN ORDER TO UPDATE ETQ (LEGACY SYSTEM) COMPLAINT NUMBER (B)(4). REASON FOR ORIGINAL COMPLAINT.- BILATERAL PATIENT. LITIGATION PAPERS ALLEGE THE FOLLOWING: FOLLOWING HIS IMPLANTATIONS, PATIENT BEGAN EXPERIENCING DEBILITATING PAIN, DISCOMFORT, AND SORENESS IN THE AREA OF BOTH OF HIS HIP IMPLANTS, WHICH IN TURN NEGATIVELY AFFECTED HIS ABILITY TO WALK, MOVE, AND GO UP AND DOWN STAIRS AND REQUIRES PATIENT'S USAGE OF A CANE. PATIENT WILL LIKELY NEED TO UNDERGO REVISION SURGERIES TO REPLACE THE IMPLANTS. UPDATE: (B)(4) 2012 PFS WAS RECEIVED FROM LEGAL, MEDICAL RECORDS WERE RECEIVED FROM LEGAL, AND PART/LOT INFORMATION WAS IDENTIFIED. RECORDS ARE AVAILABLE FOR FURTHER REVIEW. UPDATE REC'D (B)(4) 2014 - SALES REP REPORTED REVISION SURGERY OF THE LINER FOR THE RIGHT HIP. REASON FOR REVISION NOT PROVIDED. SHOULD WE RECEIVE FURTHER INFORMATION, THE COMPLAINT WILL BE UPDATED AT THAT TIME. THE COMPLAINT WAS UPDATED ON: (B)(4) 2014. UPDATE AD (B)(4) 2018: (B)(4) HAS BEEN RE-OPENED TO (B)(4) DUE TO RECEIPT OF PPF AND STICKER SHEETS. IN ADDITION TO WHAT WAS PREVIOUSLY ALLEGED, PPF ALLEGES PSEUDOTUMOR, METALLOSIS, METAL WEAR, AND ELEVATED METAL IONS. UPDATED PATIENT IDENTIFIER AND DATE OF REVISION. CORRECTED PATIENT HEIGHT. NO LABORATORY RESULTS PROVIDED. DOI: (B)(6) 2008 -DOR: MAY 14, 2012 (LEFT HIP).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PINNACLE MTL INS NEUT36IDX54OD PINNACLE HIP SYSTEM : HIP METAL ACETABULAR LINERS KWA DEPUY ORTHOPAEDICS INC US 2646336

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention