FDA Adverse Event Injury Summary report: N

MLRY-HD POR FEMORAL 14X175MM

MDR report key: 3464788 · Received November 12, 2013

Report

Report Number
0001825034-2013-05298
Event Type
Injury
Date Received
November 12, 2013
Report Date
October 14, 2013
Manufacturer
BIOMET ORTHOPEDICS
Product Code
LPH
PMA / PMN Number
PK030055
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. REVIEW OF DEVICE HISTORY RECORDS SHOW THAT LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION. THERE ARE WARNINGS IN THE PACKAGE INSERT THAT STATE THAT THIS TYPE OF EVENT CAN OCCUR: UNDER POSSIBLE ADVERSE EFFECTS, NUMBER 1 STATES, ¿MATERIAL SENSITIVITY REACTIONS.¿ NUMBER 15 STATES, ¿ELEVATED METAL ION LEVELS HAVE BEEN REPORTED WITH METAL-ON-METAL ARTICULATING SURFACES.¿ THIS REPORT IS NUMBER 3 OF 4 MDRS FILED FOR THE SAME PATIENT (REFERENCE 1825034-2013-02305-1 AND 05297/05299).

Description of Event or Problem · 1

BIOMET ORTHOPEDICS RECEIVED PRELIMINARY CLINICAL DATA FROM DR. (B)(6) REGARDING PATIENTS ENROLLED IN A (B)(4) STUDY. IT WAS REPORTED THAT PATIENT UNDERWENT TOTAL HIP ARTHROPLASTY ON (B)(6) 2010. DURING POST OPERATIVE MONITORING AND TESTING, A MASS WAS NOTED. THE MASS ON THE ANTERIOR AREA OF THE HIP MEASURED 3.6 X 3.2 X 2.5CM. THESE FINDINGS WERE FOUND DUE TO FOLLOW UP TESTING. NO FURTHER INFORMATION HAS BEEN PROVIDED AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
581667 MLRY-HD POR FEMORAL 14X175MM PROSTHESIS, HIP LPH BIOMET ORTHOPEDICS N/A 150960

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R