BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DEPUY PINNACLE SECTOR 11 ACETABULAR CUP

    MDR report key: 3050108 · Received March 15, 2013

    Report

    Report Number
    MW5029662
    Event Type
    Injury
    Date Received
    March 15, 2013
    Manufacturer
    DEPUY ORTHOPAEDICS, INC
    Product Code
    KWA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    KY, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    LEFT TOTAL HIP REPLACEMENT ON (B)(6) 2005. HE RECEIVED THE DEPUY TOTAL HIP PINNACLE ACETABULAR CUP SZ MM 60, ULTAMET METAL-ON-METAL INSERT 06MMID X 60MMOD AND ARTICULAR/EZE METAL-ON-METAL FEMORAL HEAD. IN 2007, HE BEGAN HAVING PAIN IN HIS LEFT HIP WHICH MADE IT DIFFICULT TO WALK OR PERFORM PHYSICAL ACTIVITY. THIS PAIN IS GRADUALLY WORSENING, INTERFERING WITH HIS DAILY LIFE AND LIMITING HIS MOBILITY. REASON FOR USE: OSTEONECROSIS OF LEFT HIP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    110942 DEPUY PINNACLE SECTOR 11 ACETABULAR CUP METAL-ON-METAL HIP IMPLANT KWA DEPUY ORTHOPAEDICS, INC 1217-22-060 YW8C11000
    110943 DEPUY ULTAMET METAL-ON-METAL INSERT METAL-ON-METAL HIP IMPLANT LPH DEPUY ORTHOPAEDICS, INC 121887360 1229284
    110944 DEPUY ARTICUL/EZE METAL ON METAL FEMORAL HEAD METAL-ON-METAL HIP IMPLANT JDI DEPUY ORTHOPAEDICS, INC 1365-53-000 1226764

    Patients

    Seq Age Sex Outcome Treatment
    1