FDA Adverse Event Injury Summary report: N

M2A-38 CUP NON FLARED SZ 60MM

MDR report key: 2993829 · Received March 8, 2013

Report

Report Number
0001825034-2013-00537
Event Type
Injury
Date Received
March 8, 2013
Date of Event
December 26, 2014
Report Date
February 27, 2015
Manufacturer
BIOMET ORTHOPEDICS
Product Code
KWA
PMA / PMN Number
PK011110
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. 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: UNDER POSSIBLE ADVERSE EFFECTS, NUMBER 1 STATES, "MATERIAL SENSITIVITY REACTIONS." NUMBER 6 STATES, "INADEQUATE RANGE OF MOTION DUE TO IMPROPER SELECTION OR POSITIONING OF COMPONENTS." NUMBER 14 STATES, "INTRAOPERATIVE OR POSTOPERATIVE BONE FRACTURE AND/OR POSTOPERATIVE PAIN." NUMBER 15 STATES,"ELEVATED METAL ION LEVELS HAVE BEEN REPORTED WITH METAL ON METAL ARTICULATING SURFACES." THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF'S COMPLAINT, AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED. THE FOLLOWING SECTIONS COULD NOT BE COMPLETED WITH THE LIMITED INFORMATION PROVIDED. DATE OF EVENT - N/A. DATE EXPLANTED - N/A. THIS REPORT IS NUMBER 1 OF 5 MDRS FILED FOR THE SAME EVENT (REFERENCE 1825034-2013-00537 / 00541).

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING FILED TO RELAY ADDITIONAL INFORMATION THAT WAS UNKNOWN AT THE TIME OF THE INITIAL MEDWATCH.

Additional Manufacturer Narrative · 1

THE FOLLOW-UP REPORT IS BEING FILED TO RELAY ADDITIONAL INFORMATION THAT WAS UNKNOWN AT THE TIME OF THE INITIAL MEDWATCH.

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING FILED TO RELAY ADDITIONAL INFORMATION THAT WAS UNKNOWN AT THE TIME OF THE INITIAL MEDWATCH.

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING FILED TO RELAY ADDITIONAL INFORMATION THAT WAS UNKNOWN AT THE TIME OF THE INITIAL MEDWATCH.

Description of Event or Problem · 1

PATIENT'S LEGAL COUNSEL REPORTED THAT PATIENT UNDERWENT BILATERAL TOTAL HIP ARTHROPLASTIES ON (B)(6) 2005 AND (B)(6) 2007. LEGAL COUNSEL FOR PATIENT REPORTS PATIENT ALLEGATIONS OF ELEVATED METAL ION LEVELS, TISSUE/BONE DESTRUCTION, PAIN, SWELLING, INFLAMMATION, LOSS OF RANGE OF MOTION, DYSFUNCTION, DISCOMFORT AND SORENESS. THERE HAS BEEN NO REPORTED REVISION PROCEDURE. NO FURTHER INFORMATION HAS BEEN PROVIDED TO DATE. THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF'S COMPLAINT AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED.

Description of Event or Problem · 1

PATIENT'S LEGAL COUNSEL REPORTED THAT PATIENT UNDERWENT BILATERAL TOTAL HIP ARTHROPLASTIES ON (B)(6) 2005 AND (B)(6) 2007. LEGAL COUNSEL FOR PATIENT REPORTS PATIENT ALLEGATIONS OF ELEVATED METAL ION LEVELS, TISSUE/BONE DESTRUCTION, PAIN, SWELLING, INFLAMMATION, LOSS OF RANGE OF MOTION, DYSFUNCTION, DISCOMFORT, AND SORENESS. THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF'S COMPLAINT AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED. ADDITIONAL INFORMATION RECEIVED REPORTS THE SIDE IMPLANTED (B)(6) 2007 WAS REVISED (B)(6) 2014 DUE TO PATIENT ALLEGATIONS OF PAIN AND ELEVATED ION LEVELS. THE CUP WAS REMOVED AND REPLACED. TO DATE, THERE HAS BEEN NO REPORTED REVISION PROCEDURE FOR THE SIDE IMPLANTED (B)(6) 2005.

Description of Event or Problem · 1

PATIENT'S LEGAL COUNSEL REPORTED THAT PATIENT UNDERWENT BILATERAL TOTAL HIP ARTHROPLASTIES ON (B)(6) 2005 AND (B)(6) 2007. LEGAL COUNSEL FOR PATIENT REPORTS PATIENT ALLEGATIONS OF ELEVATED METAL ION LEVELS, TISSUE/BONE DESTRUCTION, PAIN, SWELLING, INFLAMMATION, LOSS OF RANGE OF MOTION, DYSFUNCTION, DISCOMFORT, AND SORENESS. ADDITIONAL INFORMATION RECEIVED REPORTS THE RIGHT SIDE IMPLANTED (B)(6) 2007 WAS REVISED (B)(6) 2014 DUE TO PATIENT ALLEGATIONS OF PAIN AND ELEVATED ION LEVELS. THE CUP WAS REMOVED AND REPLACED. ADDITIONAL INFORMATION RECEIVED REPORTS THE LEFT SIDE IMPLANTED (B)(6) 2005 WAS REVISED (B)(6) 2014 DUE TO PAIN AND ELEVATED CHROMIUM LEVEL. THE CUP AND HEAD WERE REMOVED AND REPLACED. THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF'S COMPLAINT AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED. ADDITIONAL INFORMATION RECEIVED IN REVISION OPERATIVE REPORT NOTED PATIENT UNDERWENT A LEFT HIP REVISION ON (B)(6) 2014 DUE TO PAIN AND ELEVATED METAL ION LEVELS. OPERATIVE REPORT NOTED THE PRESENCE OF A CHRONIC-APPEARING TROCHANTERIC BURSA, DEBRIS, TRUNNION CORROSION, CAVITARY DEFECTS IN THE ACETABULUM AND NO SIGNS OF METALLOSIS. THE MODULAR HEAD AND ACETABULAR CUP WERE REMOVED AND REPLACED. ADDITIONAL INFORMATION RECEIVED IN REVISION OPERATIVE REPORT NOTED PATIENT UNDERWENT A RIGHT HIP REVISION ON (B)(6) 2014 DUE TO PAIN AND ELEVATED METAL ION LEVELS. OPERATIVE REPORT NOTED THE PRESENCE OF CHRONIC TROCHANTERIC BURSITIS, FLUID, AND CHRONIC INFLAMMATION. THE MODULAR HEAD, TAPER ADAPTER AND ACETABULAR CUP WERE REMOVED AND REPLACED.

Description of Event or Problem · 1

PATIENT'S LEGAL COUNSEL REPORTED THAT PATIENT UNDERWENT BILATERAL TOTAL HIP ARTHROPLASTIES ON (B)(6) 2005 AND (B)(6) 2007. LEGAL COUNSEL FOR PATIENT REPORTS PATIENT ALLEGATIONS OF ELEVATED METAL ION LEVELS, TISSUE/BONE DESTRUCTION, PAIN, SWELLING, INFLAMMATION, LOSS OF RANGE OF MOTION, DYSFUNCTION, DISCOMFORT, AND SORENESS. THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF'S COMPLAINT AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED. ADDITIONAL INFORMATION RECEIVED REPORTS THE RIGHT SIDE IMPLANTED (B)(6) 2007 WAS REVISED (B)(6) 2014 DUE TO PATIENT ALLEGATIONS OF PAIN AND ELEVATED ION LEVELS. THE CUP WAS REMOVED AND REPLACED. ADDITIONAL INFORMATION RECEIVED REPORTS THE LEFT SIDE IMPLANTED (B)(6) 2005 WAS REVISED (B)(6) 2014. IT WAS REPORTED THAT DURING THE REVISION PROCEDURE THE CUP WAS ALLEGEDLY NOTED TO BE WELL FIXED WITH NO OBVIOUS BONE DETERIORATION. THE CUP AND HEAD WERE REMOVED AND REPLACED.

Description of Event or Problem · 1

PATIENT'S LEGAL COUNSEL REPORTED THAT PATIENT UNDERWENT BILATERAL TOTAL HIP ARTHROPLASTIES ON (B)(6) 2005 AND (B)(6) 2007. LEGAL COUNSEL FOR PATIENT REPORTS PATIENT ALLEGATIONS OF ELEVATED METAL ION LEVELS, TISSUE/BONE DESTRUCTION, PAIN, SWELLING, INFLAMMATION, LOSS OF RANGE OF MOTION, DYSFUNCTION, DISCOMFORT, AND SORENESS. THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF'S COMPLAINT AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED. ADDITIONAL INFORMATION RECEIVED REPORTS THE RIGHT SIDE IMPLANTED (B)(6) 2007 WAS REVISED (B)(6) 2014 DUE TO PATIENT ALLEGATIONS OF PAIN AND ELEVATED ION LEVELS. THE CUP WAS REMOVED AND REPLACED. ADDITIONAL INFORMATION RECEIVED REPORTS THE LEFT SIDE IMPLANTED (B)(6) 2005 WAS REVISED (B)(6) 2014 DUE TO PAIN AND ELEVATED CHROMIUM LEVEL. THE CUP AND HEAD WERE REMOVED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
99844 M2A-38 CUP NON FLARED SZ 60MM PROSTHESIS, HIP KWA BIOMET ORTHOPEDICS N/A 767610

Patients

Seq Age Sex Outcome Treatment
1 64 YR Hospitalization| R