FDA Adverse Event Other Summary report: N

DUROM ACETABULAR COMPONENT 52/46 CODE L

MDR report key: 3032712 · Received March 19, 2013

Report

Report Number
9613350-2013-01443
Event Type
Other
Date Received
March 19, 2013
Date of Event
February 20, 2013
Report Date
February 20, 2013
Manufacturer
ZIMMER GMBH
Product Code
KWA
Removal / Correction Number
Z-2415/2426-2008
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE MFR DID NOT RECEIVE DEVICES AS THE PT HAS NOT BEEN REVISED TO DATE. WHERE LOT NUMBERS WERE RECEIVED FOR THE DEVICES, THE DEVICE HISTORY RECORDS WERE REVIEWED AND FOUND TO BE CONFORMING. BASED ON AN EXTENSIVE INVESTIGATION OF EVENTS REPORTED FROM SEVERAL USER FACILITIES OUTSIDE THE U.S., ZIMMER IDENTIFIED THAT THE MOST PROBABLE CAUSE OF THE OUTCOME OBSERVED WAS A LOOSE OR UNSTABLE CUP THAT RESULTED FROM USE OF SURGICAL TECHNIQUES NOT CONSISTENT WITH THE MFR'S RECOMMENDATIONS. AS A CORRECTIVE ACTION, A RETRAINING PROGRAM FOR USERS OUTSIDE THE U.S. WAS INITIATED IN NOV 2009 AND REPORTED TO (B)(6) 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 JUL 2008 AS (B)(4). A CLEAR CORRELATION BETWEEN THE DEVELOPED METAL ALLERGY OF THE PT AND THE PRODUCT CANNOT BE RULED OUT AS IT IS ALREADY KNOWN FOR SIMILAR METAL ON METAL (MOM) DEVICES FROM LITERATURE. OUR INVESTIGATION HAS SHOWN THAT METAL ION MEASUREMENTS FOR THE DUROM SYSTEM ARE COMPARABLE TO OTHER MOM DEVICES IN THE MARKET. AN ALLERGIC REACTION CAN BE AN INHERENT POST-OPERATIVE SIDE EFFECT AS STATED IN ZIMMER'S IFU ((B)(4)). THIS IS UNFORTUNATELY PT DEPENDENT AND CAN OCCUR WITH A LOW PERCENTAGE RATE WITH ALL KIND OF METAL ON METAL BASED PRODUCTS. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PT RECEIVED A DUROM ACETABULAR COMPONENT 52/46 CODE L ON (B)(6) 2009 ON THE LEFT HIP. THE PT IS CURRENTLY BEING MONITORED DUE TO PAIN, FLUID AROUND HIP, OSTEOLYSIS AND ELEVATED COCR LEVELS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
114797 DUROM ACETABULAR COMPONENT 52/46 CODE L DUROM ACETABULAR COMPONENT 52/46 CODE L KWA ZIMMER GMBH 2441056

Patients

Seq Age Sex Outcome Treatment
1 58 YR Other