FDA Adverse Event Injury Summary report: N

ASR ACETABULAR CUPS 62

MDR report key: 2896370 · Received January 4, 2013

Report

Report Number
1818910-2013-00347
Event Type
Injury
Date Received
January 4, 2013
Date of Event
September 25, 2012
Report Date
December 27, 2012
Manufacturer
DEPUY INTERNATIONAL
Product Code
KWA
PMA / PMN Number
K040627
Removal / Correction Number
Z1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

DEPUY STILL CONSIDERS THIS INVESTIGATION CLOSED.

Additional Manufacturer Narrative · 1

THE ASR PLATFORM WAS VOLUNTARILY RECALLED FROM THE MARKET IN AUGUST 2010, AND THE ASR PRODUCT CODES ARE NOW CONSIDERED INACTIVE. FURTHER INVESTIGATION OF THIS INDIVIDUAL INCIDENT WILL NOT BE UNDERTAKEN, AS THERE IS AN ONGOING INVESTIGATION REGARDING THE ROOT CAUSE(S) AND/OR CORRECTIVE ACTIONS. (B)(4). DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Description of Event or Problem · 1

LITIGATION ALLEGES PATIENT HAD PAIN AND INCREASED METAL LEVELS IN BLOOD AFTER ASR HIP IMPLANTS. **UPDATE** 3/11/2013 - PLAINTIFF'S PRELIMINARY DISCLOSURE FORM WAS RECEIVED, WHICH IDENTIFIED PART/LOT INFORMATION. THE COMPLAINT AND ASSOCIATED MDRS WERE UPDATED. THERE WAS NO NEW INFORMATION THAT WOULD CHANGE THE OUTCOME OF THE INVESTIGATION.

Description of Event or Problem · 1

LITIGATION ALLEGES PATIENT HAD PAIN AND INCREASED METAL LEVELS IN BLOOD AFTER ASR HIP IMPLANTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
4730 ASR ACETABULAR CUPS 62 TOTAL HIP REPLACEMENT KWA DEPUY INTERNATIONAL 2437528

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention