BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MLRY-HD POR FMRL 11X160MM

    MDR report key: 3465097 · Received November 12, 2013

    Report

    Report Number
    0001825034-2013-05268
    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 1825034-2013-02384-1 AND 05267/05267 AND 05270).

    Description of Event or Problem · 1

    BIOMET ORTHOPEDICS RECEIVED PRELIMINARY CLINICAL DATA FROM DR (B)(6) REGARDING PATIENTS ENROLLED IN A (B)(4). IT WAS REPORTED THAT A PATIENT UNDERWENT A LEFT TOTAL HIP ARTHROPLASTY ON (B)(6) 2011. DURING POST OPERATIVE MONITORING AND TESTING, FLUID COLLECTION WAS NOTED. THE COLLECTION MEASURED 2.6 X 1.8 X 2.3 CM ON THE ANTERIOR AREA OF THE LEFT HIP. 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
    581209 MLRY-HD POR FMRL 11X160MM PROSTHESIS, HIP LPH BIOMET ORTHOPEDICS N/A 473390

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R