FDA Adverse Event Injury Summary report: N

CORMET RESURFACING

MDR report key: 4584665 · Received June 17, 2014

Report

Report Number
9614209-2014-00055
Event Type
Injury
Date Received
June 17, 2014
Date of Event
January 28, 2013
Report Date
June 17, 2014
Manufacturer
CORIN MEDICAL, LTD.
Product Code
NXT
PMA / PMN Number
P050016
Adverse Event
Yes
Report Source
Manufacturer report

Narratives

Additional Manufacturer Narrative · 1

(B)(4) INITIAL REPORT: DEVICE DETAILS, PATIENT MEDICAL HISTORY, POST PRIMARY AND PRE-REVISION X-RAYS, EXPLANT ND REASON FOR REVISION HAVE BEEN REQUESTED IN ORDER TO PROGRESS WITH THE INVESTIGATION. DEVICE MANUFACTURING RECORDS TO BE REVIEWED. THE CORMET CUP AND CORMET HEAD WERE INSERTED DURING A REVISION PROCEDURE TO REPLACE A ZWEYMULLER ENDOPLUS TOTAL HIP REPLACEMENT, HOWEVER ZWEYMULLER STEM WAS RETAINED AND USED IN CONJUNCTION WITH THE CORMET DEVICES. PLEASE NOTE: THIS REPORT IS FILED WITH THE FDA DUE TO AN EVENT EXPERIENCED WITH A DEVICE THAT IS SIMILAR TO THOSE PLACED ON MARKET IN THE USA. HOWEVER, THIS EVENT OCCURRED OUTSIDE OF THE USA.

Description of Event or Problem · 1

CORMET REVISION AFTER 6 YEARS AND 10 MONTHS DUE TO PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
356922 CORMET RESURFACING METAL ON METAL RESURFACING NXT CORIN MEDICAL, LTD. 179.254B JLRG

Patients

Seq Age Sex Outcome Treatment
1 60 YR E079.948: LOT IYMZ| ASSOCIATED EUROCONE CORMET MODULAR ENDO HEAD