FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY ASR ACETABULAR CUP

MDR report key: 2946175 · Received February 6, 2013

Report

Report Number
1818910-2013-01292
Event Type
Injury
Date Received
February 6, 2013
Date of Event
July 9, 2010
Report Date
January 30, 2013
Manufacturer
DEPUY INTERNATIONAL
Product Code
KWA
Removal / Correction Number
Z-1749/1816-2011
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THIS IS A DUPLICATE REPORT OF 1818910-2010-05031. 1818910-2013-01292, WILL BE REJECTED. 1818910-2010-05031 WILL BE KEPT FOR INVESTIGATION PURPOSES.

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. REF. (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 ALLEGED THE ASR HIP WAS EXPLANTED DUE TO PAIN, METALLOSIS, DIFFICULTY AMBULATING, MUSCLE LOSS AND TISSUE DESTRUCTION AND EXPOSURE TO EXCESSIVE LEVELS OF CHROMIUM AND COBALT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
50542 UNKNOWN DEPUY ASR ACETABULAR CUP ACETABULAR CUP HIP IMPLANT KWA DEPUY INTERNATIONAL NI

Patients

Seq Age Sex Outcome Treatment
1 56 YR Other