FDA Adverse Event Injury Summary report: N

ARTICULEZE M HEAD 36MM +1.5

MDR report key: 3946258 · Received July 21, 2014

Report

Report Number
1818910-2014-23826
Event Type
Injury
Date Received
July 21, 2014
Date of Event
June 30, 2014
Report Date
July 22, 2014
Manufacturer
DEPUY ORTHOPAEDICS, INC. 1818910
Product Code
JDI
PMA / PMN Number
K980513
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE DEVICES ASSOCIATED WITH THIS REPORT WERE NOT RETURNED. REVIEW OF THE DEVICE HISTORY RECORDS AND/OR A LOT SPECIFIC COMPLAINT DATABASE SEARCH WAS NOT POSSIBLE AS THE PRODUCT AND LOT CODES REQUIRED WERE NOT PROVIDED. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY PRODUCT CONTRIBUTION TO THE REPORTED EVENT WITH THE INFORMATION PROVIDED. BASED ON THE INABILITY TO IDENTIFY ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD ANY ADDITIONAL INFORMATION BE RECEIVED TO CHANGE THE OUTCOME OF THE PERFORMED INVESTIGATION, THE COMPLAINT WILL BE RE-OPENED.

Additional Manufacturer Narrative · 1

(B)(4). THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

Additional Manufacturer Narrative · 1

NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. BASED ON PREVIOUS INVESTIGATIONS THIS COMPLICATION OF JOINT REPLACEMENT IS UNLIKELY TO HAVE BEEN THE RESULT OF A DEVICE FAILING TO MEET REQUIRED SPECIFICATIONS. THE INFORMATION RECEIVED WILL BE RETAINED FOR POTENTIAL SERIES INVESTIGATIONS IF TRIGGERED BY TREND ANALYSIS, POST MARKET SURVEILLANCE, OR OTHER EVENTS WITHIN THE QUALITY SYSTEM. CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION WILL BE RE-OPENED AS NECESSARY.

Additional Manufacturer Narrative · 1

THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

LITIGATION ALLEGES THE PATIENT SUFFERS FROM ELEVATED METAL ION LEVELS/ELEVATED LEVEL OF COBALT.

Description of Event or Problem · 1

UPDATE 12/09/2016 ¿ PFS AND MEDICAL RECORDS RECEIVED. AFTER REVIEW OF THE MEDICAL RECORDS FOR MDR REPORTABILITY, ALLEGES LEFT HIP PAIN, WEAKNESS, SUDDEN FAILURE TO HOLD WEIGHT, SHORTENING OF LEFT LEG. AN H&P ((B)(6) 2009) INDICATED THAT PATIENT HAD FIBRODYSPLASIA OF LEFT HIP AS A CHILD WITH TWO BONE GRAFTING SURGERIES, AND A LIMP WITH THE LEFT LEG BEING SHORTER THAN THE RIGHT AFTERWARDS. PROGRESS NOTE ((B)(6) 2015) STATES LEFT LEG IS SHORTER THAN THE RIGHT S/P LEFT TOTAL HIP REPLACEMENT. X-RAY REPORT OF LEFT HIP ((B)(6) 2015) INDICATES PRESENCE OF HETEROTOPIC BONE. AVAILABLE METAL ION LAB RESULTS < 7.0 MCG/L DO NOT SUPPORT METAL ION TOXICITY. ABNORMAL RESULTS: METAL IONS REMOVED FROM PRODUCT HARMS. PROD/LOT BEING UPDATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
424961 ARTICULEZE M HEAD 36MM +1.5 HIP FEMORAL HEAD JDI DEPUY ORTHOPAEDICS, INC. 1818910 3011447

Patients

Seq Age Sex Outcome Treatment
1 74 YR Required Intervention