FDA Adverse Event Injury Summary report: N

REGEN/RNGLC+ MULTI 54MM SZ 23

MDR report key: 3984408 · Received August 6, 2014

Report

Report Number
0001825034-2014-06869
Event Type
Injury
Date Received
August 6, 2014
Date of Event
June 27, 2014
Report Date
July 11, 2014
Manufacturer
BIOMET ORTHOPEDICS
Product Code
LPH
PMA / PMN Number
PK070369
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

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 4 STATES, ¿LOOSENING OR MIGRATION OF THE IMPLANTS MAY OCCUR DUE TO LOSS OF FIXATION, TRAUMA, MALALIGNMENT, BONE RESORPTION, EXCESSIVE ACTIVITY.¿

Description of Event or Problem · 1

IT WAS REPORTED PATIENT UNDERWENT A TOTAL HIP ARTHROPLASTY ON (B)(6) 2013. SUBSEQUENTLY, PATIENT WAS REVISED ON (B)(6) 2014 DUE TO A LOOSE ACETABULAR CUP. THE ACETABULAR CUP WAS REMOVED AND REPLACED WITH COMPETITOR PRODUCT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
461945 REGEN/RNGLC+ MULTI 54MM SZ 23 PROSTHESIS, HIP LPH BIOMET ORTHOPEDICS N/A 013770

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R