FDA Adverse Event Injury Summary report: N

DUROM ACETABULAR COMPONENT

MDR report key: 2669770 · Received July 20, 2012

Report

Report Number
9613350-2012-00779
Event Type
Injury
Date Received
July 20, 2012
Date of Event
January 31, 2012
Report Date
July 11, 2012
Manufacturer
DURON ACETABULAR COMPONENT AND METASUL LZH
Product Code
KWA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE MANUFACTURER DID NOT RECEIVE DEVICES OR X-RAYS FOR REVIEW. AS NO LOT NUMBERS WERE PROVIDED FOR THE DEVICES, THE DEVICE HISTORY RECORDS COULD NOT BE REVIEWED. WITH THE INFORMATION GIVEN SO FAR, NO FURTHER INVESTIGATION IS POSSIBLE. BASED ON EXTENSIVE INVESTIGATION OF EVENTS REPORTED FROM SEVERAL USER FACILITIES OUTSIDE THE U.S., ZIMMER IDENTIFIED THAT THE MOST PROBABLE CAUSE FOR THE OUTCOME OBSERVED WAS A LOOSE OR UNSTABLE CUP THAT RESULTED FROM USE OF SURGICAL TECHNIQUES NOT CONSISTENT WITH THE MANUFACTURER'S RECOMMENDATIONS. AS A CORRECTIVE ACTION, A RETRAINING PROGRAM FOR USERS OUTSIDE THE U.S. WAS INITIATED IN (B)(4) 2009 AND REPORTED TO THE NATIONAL COMPETENT AUTHORITIES AS REQUIRED. THE DUROM CUP REPORTED IN THIS CASE IS NOT MARKETED IN THE U.S. A SIMILAR CUP, COMPATIBLE WITH THE METASUL LDH FEMORAL HEAD, IS CLEARED IN THE U.S. AND A CORRECTIVE ACTION FOR THIS PRODUCT WAS REPORTED TO THE FDA IN (B)(4) 2008 AS CORRECTION Z-2415/2426-2008. SHOULD ADDITIONAL INFORMATION INCLUDING THE FINAL INVESTIGATION RESULT BE AVAILABLE, THAT CHANGES THIS ASSESSMENT, AN AMENDED MEDICAL DEVICE REPORT WILL BE FILED. THE NEED FOR FURTHER CORRECTIVE MEASURES I NOT INDICATED AT THIS TIME AND ZIMMER (B)(4) CONSIDERS THIS CASE AS CLOSED. (B)(4).

Description of Event or Problem · 1

IT IS REPORTED THAT THE PATIENT RECEIVED AN ACETABULAR CUP, RIGHT, AND HAD TO BE REVISED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DUROM ACETABULAR COMPONENT DUROM ACETABULAR COMPONENT AND METASUL KWA DURON ACETABULAR COMPONENT AND METASUL LZH UNK

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R