FDA Adverse Event Injury Summary report: N

UNKNOWN PYROCARBON IMPLANT

MDR report key: 23642304 · Received November 25, 2025

Report

Report Number
3000931034-2025-00615
Event Type
Injury
Date Received
November 25, 2025
Date of Event
July 31, 2019
Report Date
November 25, 2025
Manufacturer
TORNIER S.A.S.
Product Code
QKW
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE REPORTED EVENT COULD NOT BE CONFIRMED, SINCE THE DEVICE(S) WERE NOT RETURNED FOR EVALUATION, AND NO OTHER ADDITIONAL INFORMATION WAS RECEIVED FROM THE CLINICAL SITE. MORE DETAILED INFORMATION ABOUT THE PATIENT'S MEDICAL HISTORY, THE EVENT DETAILS AND THE INVOLVED DEVICE(S) MUST BE AVAILABLE TO DETERMINE THE ROOT CAUSE. IF ANY ADDITIONAL INFORMATION BECOMES AVAILABLE, THE INVESTIGATION WILL BE REOPENED AND RE-EVALUATED ACCORDINGLY.

Description of Event or Problem · 0

THE MANUFACTURER RECEIVED IIS NAMED "5-YEAR RADIOGRAPHIC AND CLINICAL OUTCOMES OF PYROCARBON HEMIARTHROPLASTY FOR GLENOHUMERAL ARTHRITIS AND AVASCULAR NECROSIS" THAT CONTAINS COLLECTED DATA ON THE USAGE AND THE OUTCOMES OF PYROCARBON. THE REPORT DETAILS ANALYSIS PROVIDED FOR PROCEDURES PERFORMED TILL (B)(6) 2019. DURING THE REVIEW OF THE REPORT, IT WAS NOT POSSIBLE TO ESTABLISH A SPECIFIC DEVICE DETAIL, PATIENT INFORMATION, AND CURRENTLY NO ADDITIONAL DEVICE INFORMATION IS AVAILABLE; HOWEVER, THE FOLLOWING ADVERSE EVENT WAS REPORTED: ONE PATIENT DEMONSTRATED SEVERE MEDIALIZATION AT 2 YEARS, INCREASING TO THREE PATIENTS AT FINAL FOLLOW-UP, WITH A MEDIAN MEDIALIZATION OF 10.2MM. THIS IS CASE 1 OF 3.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2851933 UNKNOWN PYROCARBON IMPLANT SHOULDER JOINT HUMERAL (HEMI-SHOULDER) CERAMIC HEAD/METALLIC STEM CEMENTED QKW TORNIER S.A.S. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other