FDA Adverse Event Injury Summary report: N

PINNACLE SECTOR II CUP 54MM

MDR report key: 3440925 · Received October 31, 2013

Report

Report Number
1818910-2013-32158
Event Type
Injury
Date Received
October 31, 2013
Date of Event
October 25, 2013
Report Date
January 7, 2014
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
LPH
PMA / PMN Number
PK000306
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, 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

THE DEVICES ASSOCIATED WITH THIS REPORT WERE NOT RETURNED. A COMPLAINT DATABASE SEARCH FOUND ONE ADDITIONAL COMPLAINT AGAINST THE 2852200 LOT CODE. PER WI-3430, REVISION C, A REVIEW OF THE DEVICE HISTORY RECORDS IS NO LONGER REQUIRED FOR THIS PRODUCT. A COMPLAINT DATABASE SEARCH FINDS NO OTHER REPORTED INCIDENTS AGAINST THE REMAINING PRODUCT AND LOT COMBINATIONS. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY PRODUCT CONTRIBUTION TO THE REPORTED EVENT WITH THE INFORMATION PROVIDED. BASED ON THE INABILITY TO IDENTIFY 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

IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE. UPDATE REC'D (B)(4) 2014- PFS AND MEDICAL RECORDS RECEIVED. A DOR WAS PROVIDED. THE INVESTIGATION IS ONGOING. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

Description of Event or Problem · 1

LITIGATION ALLEGES PAIN, INSTABILITY, ELEVATED LEVELS OF COBALT AND CHROMIUM, SUBLUXATION, LOSS OF MOBILITY AND AUDIBLE NOISES. UPDATE (B)(4) 2013 - THE COMPLAINT HAS BEEN REOPENED BECAUSE IT WAS REPORTED THAT THE PATIENT'S LEFT HIP WAS REVISED ON (B)(6) 2013 TO ADDRESS MALPOSITIONING OF THE CUP, SUBLUXATION, AND INSTABILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
559598 PINNACLE SECTOR II CUP 54MM ACETABULAR CUP LPH DEPUY ORTHOPAEDICS INC US D42HK1000

Patients

Seq Age Sex Outcome Treatment
1 46 YR Required Intervention