FDA Adverse Event Injury Summary report: N

BHR

MDR report key: 3171775 · Received June 17, 2013

Report

Report Number
3005477969-2013-00240
Event Type
Injury
Date Received
June 17, 2013
Date of Event
February 26, 2011
Report Date
August 8, 2013
Manufacturer
SMITH & NEPHEW ORTHOPAEDICS, LTD.
Product Code
NXT
PMA / PMN Number
P040033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION:UPON RECEIPT OF NEW INFORMATION, IT HAS BEEN IDENTIFIED THAT THIS EVENT WAS REPORTED TWICE THROUGH DIFFERENT SOURCES, AND AS SUCH, THIS MDR (REF. 3005477969-2013-00240) IS A DUPLICATION OF A PREVIOUSLY REPORTED MDR (MDR REF. 3005477969-2012-00032).

Additional Manufacturer Narrative · 1

THE USE OF A COMPETITOR'S FEMORAL STEM IN CONJUNCTION WITH THE DEVICES CONCERNED CONSTITUES AN OFF LABEL APPLICATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE HIP DEVICES WERE REVISED DUE TO ASEPTIC LOOSENING OF THE SOCKET AND ASEPTIC LOOSENING OF THE FEMORAL STEM.

Description of Event or Problem · 1

IT WAS REPORTED THAT REVISION SURGERY WAS PERFORMED IN (B)(6) 2011 DUE TO AN ADVERSE REACTION TO METAL DEBRIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
272774 BHR ACETABULAR CUP NXT SMITH & NEPHEW ORTHOPAEDICS, LTD. 50485

Patients

Seq Age Sex Outcome Treatment
1 60 YR Hospitalization| R ZIMMER CPT STEM, PART AND LOT # UNKNOWN| FEMORAL HEAD, PART AND LOT # UNKNOWN