FDA Adverse Event Injury Summary report: N

NV GXL LINER NEUTRAL, 32MM ID GROUP 1 CUPS

MDR report key: 24455718 · Received February 26, 2026

Report

Report Number
1038671-2026-00191
Event Type
Injury
Date Received
February 26, 2026
Date of Event
January 19, 2026
Report Date
February 26, 2026
Manufacturer
EXACTECH, INC.
Product Code
MEH
UDI-DI
10885862207074
PMA / PMN Number
K121392
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PO
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

D10: 164-02-08 - ELEMENT-STEM, COLLARLESS W/HA, HIGH OFFSET, SZ 8: (B)(6), 186-01-50 - INTEGRIP CC, CLUSTER 50MM, G1, CLUSTER: (B)(6), 01-032-03-3294 - UNIVERSAL CUP, HEAD, DELTA, 32MM, -4: 1711.7523.217/001. THE REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. NO DEVICE WAS RETURNED FOR EVALUATION; FURTHER, PHOTOGRAPHS AND/OR RADIOGRAPH IMAGES WERE NOT PROVIDED FOR REVIEW. OPERATIVE NOTES AND/OR MEDICAL RECORDS WERE NOT PROVIDED FOR REVIEW OF USAGE/TECHNIQUE. A DEFINITIVE ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. IF ANY FURTHER INFORMATION IS OBTAINED THAT WOULD CHANGE OR ALTER ANY INFORMATION PROVIDED, A SUPPLEMENTAL REPORT WILL BE FILED ACCORDINGLY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT AN INITIAL TOTAL HIP ARTHROPLASTY. SUBSEQUENTLY, THE PATIENT EXPERIENCING DISCOMFORT. ACCORDING TO THE PHYSICIAN, THE PATIENT HAD PREMATURE WEAR. THE DEVICE REMAINS IMPLANTED. NO FURTHER INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
520327 NV GXL LINER NEUTRAL, 32MM ID GROUP 1 CUPS PROSTHESIS, HIP, SEMI-CONSTRAINED, UNCEMENTED, METAL/POLYMER, NON-POROUS, CALICU MEH EXACTECH, INC. 10885862207074

Patients

Seq Age Sex Outcome Treatment
1 71 YR Female Hospitalization SEE H11