FDA Adverse Event Injury Summary report: N

ARTICULEZE M HEAD 36MM -2

MDR report key: 3952467 · Received July 23, 2014

Report

Report Number
1818910-2014-24060
Event Type
Injury
Date Received
July 23, 2014
Date of Event
July 3, 2014
Report Date
November 6, 2014
Manufacturer
DEPUY INTERNATIONAL LTD. 8010379
Product Code
JDI
PMA / PMN Number
PK980513
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE PATIENT WAS REVISED BECAUSE OF INFECTION. EXAMINATION OF THE REPORTED DEVICES WAS NOT POSSIBLE AS THEY WERE NOT RETURNED. A SEARCH OF THE COMPLAINTS DATABASES FINDS NO OTHER REPORTS AGAINST THE PRODUCT AND LOT CODE COMBINATIONS SINCE THEIR RELEASE TO DISTRIBUTION. THE INVESTIGATION CAN DRAW NO CONCLUSION WITH THE INFORMATION PROVIDED. BASED ON THE INABILITY TO DETERMINE ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION HAS NOT BEEN INDICATED.

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.

Additional Manufacturer Narrative · 1

NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. A WORLDWIDE COMPLAINT DATABASE SEARCH FOUND NO OTHER REPORTED INCIDENT(S) AGAINST THE PROVIDED PRODUCT/LOT COMBINATION(S) SINCE RELEASE FOR DISTRIBUTION. 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

(B)(4). 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.(B)(4).

Description of Event or Problem · 1

THE PATIENT WAS REVISED BECAUSE OF INFECTION.

Description of Event or Problem · 1

UPDATE REC'D 11/06/2014 - THE PATIENT'S MEDICAL RECORDS WERE RECEIVED. RECORDS WERE REVIEWED FOR MDR REPORTABILILTY. THE PATIENT'S MEDICAL RECORDS INDICATE THE PATIENT WAS EXPERIENCING PAIN AS WELL. THE PATIENT'S LOT CODE FOR THEIR ACETABULAR LINER IS BEING UPDATED. THERE IS NO NEW INFORMATION THAT WOULD CHANGE THE EXISTING MDR DECISION.THE COMPLAINT WAS UPDATED ON: 11/24/2014.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
431042 ARTICULEZE M HEAD 36MM -2 HIP FEMORAL HEAD JDI DEPUY INTERNATIONAL LTD. 8010379 7890095

Patients

Seq Age Sex Outcome Treatment
1 46 YR Required Intervention