FDA Adverse Event Injury Summary report: N

M2A-MAGNUM PF CUP 60ODX54ID

MDR report key: 2580384 · Received May 18, 2012

Report

Report Number
0001825034-2012-00635
Event Type
Injury
Date Received
May 18, 2012
Date of Event
April 16, 2012
Report Date
April 20, 2012
Manufacturer
BIOMET ORTHOPEDICS
Product Code
KWA
PMA / PMN Number
PK042037
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

REVIEW OF DEVICE HISTORY RECORDS SHOW THAT LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION. THERE ARE WARNINGS IN THE PACKAGE INSERT THAT STATE THAT THIS TYPE OF EVENT CAN OCCUR: "LOOSENING OR MIGRATION OF THE IMPLANTS MAY OCCUR DUE TO LOSS OF FIXATION, TRAUMA, MALALIGNMENT, BONE RESORPTION, OR EXCESSIVE ACTIVITY." EVALUATION IN PROCESS BUT NOT YET COMPLETE. UPON COMPLETION OF EVALUATION, A FOLLOW UP REPORT WILL BE SENT TO THE FDA. THIS REPORT IS NUMBER 1 OF 4 MDRS FILED FOR THE SAME EVENT (REFERENCE 1825034-2012-00635 / 00638).

Additional Manufacturer Narrative · 1

REVIEW OF EXPLANTED DEVICE SHOWS EVIDENCE OF SCRATCHING AND METALLIC TRANSFER MARKS ON THE ARTICULAR SURFACE OF THE ACETABULAR CUP. THERE ARE HEAVIER SCRATCHES ON THE RIM OF THE CUP THAT MAY HAVE BEEN CAUSED BY SURGICAL INSTRUMENTS DURING REMOVAL OF THE CUP. WEAR OR DEFORMATION MARKS WERE OBSERVED ON THE RIM OF THE FRONT FACE OF THE CUP, WHICH MAY HAVE BEEN CAUSED BY STEM IMPINGEMENT OR DISLOCATION OR SUBLUXATION OF THE MODULAR HEAD. THERE WAS NO EVIDENCE OF CHANGES IN SURFACE CONTOUR AT THE EDGES OF THE CONTACT AREA, FROM WHICH IT IS INFERRED THAT WEAR RATES WERE NOT EXCESSIVE. THE POROUS COATING ON THE ACETABULAR CUP APPEARS TO BE INTACT AND SHOWED LITTLE EVIDENCE OF BONY INGROWTH. THE ROOT CAUSE OF THE LOOSENING OF THE CUP COULD NOT BE ESTABLISHED. THIS FOLLOW-UP REPORT IS NUMBER 1 OF 4 MDRS FILED FOR THE SAME EVENT (REFERENCE 1825034-2012-00635-1 / 00638-1).

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT TOTAL HIP ARTHROPLASTY ON (B)(6) 2007. SUBSEQUENTLY, A REVISION PROCEDURE WAS PERFORMED ON (B)(6) 2012 DUE TO LOOSENING. THE SURGEON REPORTEDLY COULD NOT DISENGAGE THE TAPER FROM THE STEM. ALL COMPONENTS WERE REMOVED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 M2A-MAGNUM PF CUP 60ODX54ID PROSTHESIS, HIP KWA BIOMET ORTHOPEDICS N/A 139090

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R