FDA Adverse Event Other Summary report: N

DUROM ACETABULAR COMPONENT 56/50 CODE P

MDR report key: 3875196 · Received May 30, 2014

Report

Report Number
9613350-2014-03581
Event Type
Other
Date Received
May 30, 2014
Date of Event
May 6, 2014
Report Date
May 6, 2014
Manufacturer
ZIMMER GMBH
Product Code
KWA
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE MANUFACTURER DID NOT RECEIVED DEVICES OR X-RAYS FOR REVIEW. AS NO LOT NUMBERS WERE PROVIDED FOR THE DEVICES, THE DEVICE HISTORY RECORDS COULD NOT BE REVIEWED. BASED ON AN EXTENSIVE INVESTIGATION OF EVENTS, REPORTED FROM SEVERAL USER FACILITIES OUTSIDE THE USA, ZIMMER IDENTIFIED THAT THE MOST PROBABLE CAUSE FOR THE OUTCOME OBSERVED WAS A LOOSE OR UNSTABLE CUP THAT RESULTED FROM USE OF SURGICAL TECHNIQUES NOT CONSISTENT WITH THE MANUFACTURER'S RECOMMENDATIONS. AS A CORRECTIVE ACTION, A RETRAINING PROGRAM FOR USERS OUTSIDE THE USA WAS INITIATED IN NOVEMBER 2009 AND REPORTED TO THE NATIONAL COMPETENT AUTHORITIES AS REQUIRED. THE DUROM CUP REPORTED IN THIS CASE IS NOT MARKETED IN THE USA. A SIMILAR CUP, COMPATIBLE WITH THE METASUL LDH FEMORAL HEAD, IS CLEARED IN THE USA AND A CORRECTIVE ACTION FOR THIS PRODUCT WAS REPORTED TO THE FDA IN JULY 2008 AS NOTIFICATION Z-2415/2426-2008. SINCE THIS CASE IS RELATED TO THE ISSUES FOR WHICH ZIMMER IMPLEMENTED A CORRECTIVE ACTION THERE WILL BE NO FURTHER INVESTIGATION. ZIMMER'S REFERENCE NUMBER OF THIS FILE IS (B)(4).

Additional Manufacturer Narrative · 1

SINCE THIS CASE IS RELATED TO THE ISSUES FOR WHICH ZIMMER IMPLEMENTED A CORRECTIVE ACTION WHICH WAS REPORTED TO THE FDA IN JULY 2008 AS CORRECTION Z-2415/2426-2008, THERE WILL BE NO FURTHER INVESTIGATION AND ZIMMER (B)(4) WILL CLOSE THIS CASE ONCE AGAIN. (B)(4).

Description of Event or Problem · 1

IT HAS NOW BEEN REPORTED THAT THE PATIENT WAS IMPLANTED A DUROM ACETABULAR COMPONENT 56/50 CODE P. THIS IS A BILATERAL CLAIM.

Description of Event or Problem · 1

A PRODUCT LIABILITY CLAIM WAS RAISED. IT WAS REPORTED THAT THE PATIENT WAS IMPLANTED A DUROM ACETABULAR COMPONENT 56/50 CODE P ON THE RIGHT SIDE OF (B)(6) 2006. CURRENTLY, THE PATIENT IS BEING MONITORED DUE TO UNKNOWN REASONS. LEFT COMPLAINT: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
318739 DUROM ACETABULAR COMPONENT 56/50 CODE P DUROM ACETABULAR COMPONENT KWA ZIMMER GMBH N/A UNK

Patients

Seq Age Sex Outcome Treatment
1 58 YR Other