FDA Adverse Event Injury Summary report: N

PINN SECTOR W/GRIPTION 56MM

MDR report key: 3058213 · Received April 15, 2013

Report

Report Number
1818910-2013-15373
Event Type
Injury
Date Received
April 15, 2013
Report Date
April 3, 2013
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
LPH
PMA / PMN Number
K071784
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

THIS COMPLAINT IS STILL UNDER INVESTIGATION. 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 CODE EX1D51000. A SEARCH OF THE COMPLAINT DATABASE FINDS ADDITIONAL REPORTED INCIDENTS AGAINST LOT CODES 3144978 AND 2854891 SINCE ITS RELEASE FOR DISTRIBUTION; HOWEVER, A REVIEW OF THE DEVICE HISTORY RECORDS DID NOT REVEAL ANY RELATED MANUFACTURING ANOMALIES. MEDICAL RECORDS WERE OBTAINED AND REVIEWED BY A MEDICAL PROFESSIONAL. 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. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION WILL BE RE-OPENED AS NECESSARY.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

LITIGATION ALLEGES THAT THE PATIENT SUFFERS FROM PAIN, DISCOMFORT, SORENESS, DIFFICULTY WITH DAILY LIVING ACTIVITIES, AND TOXIC COBALT CHROMIUM METAL IONS AND PARTICLES TO BE RELEASED INTO THE PATIENT'S BLOOD, TISSUE, AND BONE. UPDATE: 4/3/2013 PFS WAS RECEIVED FROM LEGAL, MEDICAL RECORDS WERE RECEIVED FROM LEGAL, AND PART/LOT INFORMATION WAS IDENTIFIED. RECORDS INDICATE THAT THE METAL INSERT WAS NOT SEATED CORRECTLY IN THE SHELL. RECORDS ARE AVAILABLE FOR FURTHER REVIEW.

Description of Event or Problem · 1

PPF ALLEGES METAL WEAR METALLOSIS. ADDED STATE, AGE, LAW FIRM, SURGEON, AND PRODUCT DETAILS. ADDED STEM DUE TO TOXIC COBALT CHROMIUM METAL IONS. DOI: (B)(6)2010 - DOR: (B)(6)2011 (RIGHT HIP)

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
160645 PINN SECTOR W/GRIPTION 56MM PINNACLE HIP SYSTEM : HIP METAL ACETABULAR CUPS LPH DEPUY ORTHOPAEDICS INC US EX1D51000

Patients

Seq Age Sex Outcome Treatment
1 49 YR Other