FDA Adverse Event Injury Summary report: N

M2A-MAGNUM PF CUP 46ODX40ID

MDR report key: 3842849 · Received June 2, 2014

Report

Report Number
0001825034-2014-05096
Event Type
Injury
Date Received
June 2, 2014
Report Date
November 4, 2015
Manufacturer
BIOMET ORTHOPEDICS
Product Code
KWA
PMA / PMN Number
PK042037
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
ATTORNEY

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 6 STATES, ¿INADEQUATE RANGE OF MOTION DUE TO IMPROPER SELECTION OR POSITIONING OF COMPONENTS.¿ NUMBER 14 STATES, ¿INTRAOPERATIVE OR POSTOPERATIVE BONE FRACTURE AND/OR POSTOPERATIVE PAIN.¿ NUMBER 15 STATES, ¿ELEVATED METAL ION LEVELS HAVE BEEN REPORTED WITH METAL-ON-METAL ARTICULATING SURFACES.¿ THIS REPORT IS NUMBER 1 OF 2 MDRS FILED FOR THE SAME EVENT (REFERENCE 1825034-2014-05096 / 05097).

Additional Manufacturer Narrative · 1

THIS FOLLOW-UP REPORT IS BEING FILED TO RELAY ADDITIONAL INFORMATION, WHICH WAS UNKNOWN AT THE TIME OF THE INITIAL MEDWATCH. THERE ARE WARNINGS IN THE PACKAGE INSERT THAT STATE THAT THIS TYPE OF EVENT CAN OCCUR: UNDER POSSIBLE ADVERSE EFFECTS, NUMBER 6 STATES, ¿INADEQUATE RANGE OF MOTION DUE TO IMPROPER SELECTION OR POSITIONING OF COMPONENTS.¿ NUMBER 8 STATES, "DISLOCATION AND SUBLUXATION DUE TO INADEQUATE FIXATION AND IMPROPER POSITIONING." NUMBER 14 STATES, ¿INTRAOPERATIVE OR POSTOPERATIVE BONE FRACTURE AND/OR POSTOPERATIVE PAIN.¿ NUMBER 15 STATES, ¿ELEVATED METAL ION LEVELS HAVE BEEN REPORTED WITH METAL-ON-METAL ARTICULATING SURFACES.¿

Description of Event or Problem · 1

LEGAL COUNSEL FOR PATIENT REPORTED PATIENT UNDERWENT LEFT TOTAL HIP ARTHROPLASTY ON (B)(6) 2009. LEGAL COUNSEL FOR PATIENT REPORTED PATIENT ALLEGATIONS OF ELEVATED METAL ION LEVELS, POPPING, CLICKING AND GRINDING IN HIP, LOSS OF RANGE OF MOTION, PAIN, AND LACK OF MOBILITY. THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF'S COMPLAINT AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED.

Description of Event or Problem · 1

LEGAL COUNSEL FOR PATIENT REPORTED PATIENT UNDERWENT LEFT TOTAL HIP ARTHROPLASTY ON (B)(6) 2009. LEGAL COUNSEL FOR PATIENT REPORTED PATIENT ALLEGATIONS OF ELEVATED METAL ION LEVELS, POPPING, CLICKING AND GRINDING IN HIP, LOSS OF RANGE OF MOTION, PAIN, AND LACK OF MOBILITY. THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF'S COMPLAINT AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED. PATIENT REPORTED ADDITIONAL ALLEGATIONS OF DISLOCATIONS, HYPOTHYROID, NEUROPATHY, HA, HAIR LOSS, AND HEARING PROBLEMS. ADDITIONAL INFORMATION RECEIVED IN POST-OPERATIVE MONITORING REPORT NOTED A FEMUR FRACTURE DURING THE INITIAL PROCEDURE ON (B)(6) 2009. CABLES WERE IMPLANTED TO SECURE THE BONE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
320876 M2A-MAGNUM PF CUP 46ODX40ID PROSTHESIS, HIP KWA BIOMET ORTHOPEDICS N/A 593750

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R