FDA Adverse Event Injury Summary report: N

LINEAGE(R) TRANSCEND(R) CERAMIC FEMORAL HEAD

MDR report key: 4250970 · Received November 14, 2014

Report

Report Number
3010536692-2014-01662
Event Type
Injury
Date Received
November 14, 2014
Date of Event
October 17, 2014
Report Date
October 17, 2014
Manufacturer
MICROPORT ORTHOPEDICS INC.
Product Code
LPH
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS NOT COMPLETE. TRENDS WILL BE EVALUATED. THIS REPORT WILL BE UPDATED WHEN THE INVESTIGATION IS COMPLETE. THIS IS THE SAME EVENT AS 3010536692-2014-01660, 01661.

Additional Manufacturer Narrative · 1

THE COMPLAINT DATABASE WAS REVIEWED AND ANALYSIS SHOWED NO TREND FOR ITEM/LOT.

Description of Event or Problem · 1

ALLEGEDLY PER DX WAS REVISION DUE TO POSSIBLE FX DISLOCATION OF CUP LINER. LINER WAS DISLOCATED AND NOT IN THE CUP. THERE WAS LARGE AMOUNTS OF BLACK TISSUE, PRESUMABLY FROM METAL-ON-HEAD WEAR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
738350 LINEAGE(R) TRANSCEND(R) CERAMIC FEMORAL HEAD HIP COMPONENT LPH MICROPORT ORTHOPEDICS INC. 2600-00XX NI

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention