FDA Adverse Event Injury Summary report: N

DUR DYNAMIC LOCK RING 60 OR 72

MDR report key: 3110821 · Received May 14, 2013

Report

Report Number
1818910-2013-17013
Event Type
Injury
Date Received
May 14, 2013
Date of Event
May 9, 2013
Report Date
May 9, 2013
Manufacturer
DEPUY ORTHOPAEDICS
Product Code
LPH
PMA / PMN Number
PP880025
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN

Narratives

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

EXAMINATION OF THE REPORTED DEVICES WAS NOT POSSIBLE AS THEY WERE NOT RETURNED. A SEARCH OF THE COMPLAINTS DATABASES FINDS NO OTHER REPORTS AGAINST THE PRODUCT AND LOT CODE COMBINATIONS SINCE THEIR RELEASE TO DISTRIBUTION. A REVIEW OF DEVICE HISTORY RECORDS FINDS NO RELATED MANUFACTURING DEVIATIONS OR ANOMALIES THAT WOULD HAVE CONTRIBUTED TO THE REPORTED EVENT. REVIEW OF PROVIDED PATIENT X-RAYS BY DEPUY CPD FINDS DISLOCATION OF THE PROXIMAL FEMUR NOTED. RETAINING RING ALSO DISASSOCIATED FROM THE LINER/CUP. FROM AN ENGINEERING STANDPOINT NO OTHER CONCLUSIONS CAN BE DRAWN FROM THE X-RAY. ADDITIONALLY, RESEARCH USING THE AS400 SYSTEM INDICATES THAT SEVERAL OTHER DEVICES FROM THE REPORTED LOTS HAVE BEEN DELIVERED AND ARE CONSIDERED SUCCESSFULLY IMPLANTED AS NO OTHER REPORTS HAVE BEEN RECEIVED. THE INVESTIGATION CAN DRAW NO CONCLUSION WITH THE INFORMATION PROVIDED. BASED ON THE INABILITY TO DETERMINE ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION HAS NOT BEEN INDICATED. DEPUY CONSIDERS THIS INVESTIGATION CLOSED. SHOULD THE PRODUCT OR ADDITIONAL INFORMATION THAT CHANGES THIS CONCLUSION BE RECEIVED, THE INVESTIGATION WILL BE REOPENED.

Description of Event or Problem · 1

REASON FOR REVISION: RECURRENT DISLOCATION. PATIENT INITIALLY DID WELL FOR THE FOLLOWING THREE YEARS AND 4 MONTHS AND HAS RECENTLY EXPERIENCED A DISLOCATION. ON X-RAY IT WAS NOTED THAT THE CONSTRAINED LINER LOCKING RING HAD DISSOCIATED AND THE PATIENT HAD DISLOCATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
212045 DUR DYNAMIC LOCK RING 60 OR 72 LOCKING RING LPH DEPUY ORTHOPAEDICS A3VJ61000

Patients

Seq Age Sex Outcome Treatment
1 81 YR Required Intervention