FDA Adverse Event Injury Summary report: N

PINNACLE SECTOR II CUP 58MM

MDR report key: 2949000 · Received February 7, 2013

Report

Report Number
1818910-2013-01431
Event Type
Injury
Date Received
February 7, 2013
Date of Event
October 12, 2010
Report Date
October 23, 2012
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
LPH
PMA / PMN Number
K983014
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS ONGOING. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

Additional Manufacturer Narrative · 1

THE DEVICES ASSOCIATED WITH THIS REPORT WERE NOT RETURNED. A SEARCH OF THE COMPLAINT DATABASE FOUND NO ADDITIONAL RELATED REPORTS FOR THE LOT CODES 2147447, A36D91, AND X61DV1. A SEARCH OF THE COMPLAINT DATABASE SEARCH FINDS ADDITIONAL REPORTED INCIDENTS AGAINST LOT CODE 2251737 SINCE ITS RELEASE FOR DISTRIBUTION; HOWEVER, A REVIEW OF THE DEVICE HISTORY RECORDS DID NOT REVEAL ANY RELATED MANUFACTURING ANOMALIES. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY PRODUCT CONTRIBUTION TO THE REPORTED EVENT WITH THE INFORMATION PROVIDED. BASED ON THE INABILITY TO DETERMINE A ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD ANY ADDITIONAL INFORMATION BE RECEIVED TO CHANGE THE OUTCOME OF THE PERFORMED INVESTIGATION, THE COMPLAINT WILL BE RE-OPENED.

Additional Manufacturer Narrative · 1

(B)(4). ADDED: PATIENT, DEVICE.

Description of Event or Problem · 1

LITIGATION ALLEGES THAT THE PATIENT SUFFERS FROM PAIN, SWELLING, INFLAMMATION, INFECTION, AND DAMAGE TO SURROUNDING BONE AND TISSUE, MULTIPLE DISLOCATIONS AND LACK OF MOBILITY. UPDATE: 1/17/2013 PFS WAS RECEIVED FROM LEGAL, MEDICAL RECORDS WERE RECEIVED FROM LEGAL, AND PART/LOT INFORMATION WAS IDENTIFIED. RECORDS INDICATE THAT THE PATIENT WAS REVISED ON (B)(6) 2010 FOR INFECTION WHERE EVERYTHING WAS REMOVED AND ANTIBIOTIC SPACER WAS PUT IN. THE PATIENT WAS REIMPLANTED ON (B)(6) 2010. RECORDS ARE AVAILABLE FOR FURTHER REVIEW.

Description of Event or Problem · 1

IN ADDITION TO WHAT WERE PREVIOUSLY ALLEGED, PPF ALLEGES PSEUDOTUMOR, LOOSENING OF CUP, METALLOSIS, METAL WEAR AND ELEVATED METAL IONS. ALL PRODUCTS WERE ALREADY ADDED. UPDATED DATE OF REVISION. ADDED REVISION HOSPITAL, REVISION SURGEON, LAWYER IN THE ASSOCIATED CONTACT AND LAW FIRM IN THE FACILITY NAME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
53003 PINNACLE SECTOR II CUP 58MM PINNACLE HIP SYSTEM : HIP METAL ACETABULAR CUPS LPH DEPUY ORTHOPAEDICS INC US A36D91000

Patients

Seq Age Sex Outcome Treatment
1 45 YR Required Intervention