BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PINNACLE MTL INS NEUT40IDX60OD

    MDR report key: 3202628 · Received July 2, 2013

    Report

    Report Number
    1818910-2013-20407
    Event Type
    Injury
    Date Received
    July 2, 2013
    Date of Event
    June 17, 2013
    Report Date
    June 19, 2013
    Manufacturer
    DEPUY ORTHOPAEDICS INC US
    Product Code
    KWA
    PMA / PMN Number
    PK062426
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE ASSOCIATED WITH THIS REPORT WAS NOT RETURNED. A SEARCH OF THE COMPLAINT DATABASE AND/OR DHR REVIEW WAS NOT POSSIBLE AS THE PRODUCT AND LOT CODE REQUIRED WAS NOT PROVIDED. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS REGARDING THE REPORTED EVENT WITH THE INFORMATION AVAILABLE. BASED ON THE INABILITY TO DETERMINE A ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD ANY ADDITIONAL INFORMATION BE RECEIVED TO CHANGE THE OUTCOME OF THE PERFORMED INVESTIGATION, THE COMPLAINT WILL BE RE-OPENED.

    Additional Manufacturer Narrative · 1

    THE 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 REVIEW OF THE DHR (DEVICE HISTORY RECORD) FOR PRODUCT NUMBERS 121887460 AND 136505000 LOT NUMBERS 2982978 AND 2840583 FOUND NO ANOMALIES. NO PATIENT X-RAYS WERE PROVIDED TO EXAMINE AND POSITIONING CANNOT BE COMMENTED UPON. PATIENT MEDICAL RECORDS WERE RECEIVED AND REVIEWED. AMONG OTHER CONDITIONS, EXCESSIVE PATIENT WEIGHT TENDS TO ADVERSELY AFFECT JOINT REPLACEMENT IMPLANTS. IT IS NOT KNOWN TO WHAT EXTENT, IF ANY, THIS MAY HAVE BEEN A FACTOR IN THE REPORTED PROBLEM. IT IS NOT POSSIBLE TO DETERMINE THAT THE IMPLANTS CONTRIBUTED TO THE REPORTED EVENTS. THE INVESTIGATION CAN DRAW NO CONCLUSIONS WITH THE INFORMATION PROVIDED. BASED ON THE INABILITY TO DETERMINE ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION HAS NOT BEEN INDICATED.

    Description of Event or Problem · 1

    LITIGATION ALLEGES THAT THE PATIENT SUFFERS FROM PAIN, DISCOMFORT, INFLAMMATION, POPPING NOISES, NERVE DAMAGE AND DIFFICULTY AMBULATING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    302644 PINNACLE MTL INS NEUT40IDX60OD METAL LINER KWA DEPUY ORTHOPAEDICS INC US 2982978

    Patients

    Seq Age Sex Outcome Treatment
    1 45 YR Other