FDA Adverse Event Injury Summary report: N

HA TAPERLOC POR LAT FEMORAL 12.5X145

MDR report key: 3945754 · Received July 21, 2014

Report

Report Number
0001825034-2014-06258
Event Type
Injury
Date Received
July 21, 2014
Date of Event
December 9, 2013
Report Date
July 10, 2014
Manufacturer
BIOMET ORTHOPEDICS
Product Code
LPH
PMA / PMN Number
PK030055
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
KY, 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: 4. LOOSENING OR MIGRATION OF THE IMPLANTS MAY OCCUR DUE TO LOSS OF FIXATION, TRAUMA, MALALIGNMENT, BONE RESORPTION, EXCESSIVE ACTIVITY. FOURTEEN: INTRAOPERATIVE OR POSTOPERATIVE BONE FRACTURE AND/OR POSTOPERATIVE PAIN. THIS REPORT IS NUMBER 2 OF 2 MDRS FILED FOR THE SAME EVENT (REFERENCE 1825034-2014-05079 AND 06258).

Description of Event or Problem · 1

LEGAL COUNSEL FOR PATIENT REPORTED PATIENT UNDERWENT A RIGHT TOTAL HIP ARTHROPLASTY ON (B)(6) 2010. PATIENT'S LEGAL COUNSEL FURTHER REPORTED THAT A REVISION PROCEDURE WAS PERFORMED ON (B)(6) 2013 DUE TO PATIENT ALLEGATIONS OF PAIN. A REVIEW OF THE INVOICE HISTORY CONFIRMED BOTH SURGERY DATES AND INDICATES THE ACETABULAR LINER WAS REMOVED AND REPLACED WITH A CONSTRAINED LINER DURING THE REVISION PROCEDURE. ADDITIONAL INFORMATION PROVIDED IN PATIENT MEDICAL RECORDS INDICATES THE RIGHT HIP REVISION PERFORMED ON (B)(6) 2013 WAS DUE TO PAIN AND FEMORAL LOOSENING. THE PATIENT¿S OPERATIVE REPORT NOTED LINER AND FEMORAL STEM WERE REMOVED. THE FEMORAL STEM WAS REPLACED WITH A COMPETITOR¿S STEM COMPONENT. THIS REPORT IS BASED ON ALLEGATIONS SET FORTH IN PLAINTIFF'S COMPLAINT AND THE ALLEGATIONS CONTAINED THEREIN ARE UNVERIFIED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
426635 HA TAPERLOC POR LAT FEMORAL 12.5X145 PROSTHESIS, HIP LPH BIOMET ORTHOPEDICS N/A 675820

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R