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U.S. Department of Health and Human Services

Class 3 Device Recall Conserve Cups

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  Class 3 Device Recall Conserve Cups see related information
Date Initiated by Firm June 21, 2016
Date Posted December 01, 2016
Recall Status1 Terminated 3 on July 01, 2017
Recall Number Z-0688-2017
Recall Event ID 75063
510(K)Number K100866  
Product Classification Prosthesis, hip, semi-constrained, metal/ceramic/polymer, cemented or non-porous, uncemented - Product Code LZO
Product Conserve Cups: REF 38BF3642, REF 38BF3642SP, REF 38BF3844, REF 38BF3844SP, REF 38BF4046, REF 38BF4046SP, REF 38BF4248, REF 38BF4248SP, REF 38BF4450, REF 38BF4450SP,
REF 38BF4652, REF 38BF4652SP, REF 38BF4854, REF 38BF5056, REF 38BF5258, REF 38BF5258SP, REF 38BF5460, REF 38BF5460SP, REF 38BF5662, REF 38BF5662SP, REF 38BF5864,
REF 38BF5864SP, REF 38BF6066, REF 38BF6066SP, REF 38QH3644, REF 38QH3846, REF 38QH4048, REF 38QH4250, REF 38QH4452, REF 38QH4654, REF 38QH4856, REF 38QH5058,
REF 38QH5260, REF 38QH5462, REF 38QH5664, REF 38QH5666, REF 38SC3650, REF 38SC3852,
REF 38SC4054, REF 38SC4256, REF 38SC4458, REF 38SC4660, REF 38SC4862, REF 38SC5064, REF 38SC5266, REF 38SC5468, REF 38SC5670, REF 38SC5672
For use with the conserve metal head
Code Information REF 38BF3642 Serial Numbers: 1380112, 1399025, 1402166, 1340677, 1427276, 1429743   REF 38BF3642SP Serial Number 1416590  REF 38BF3844 Serial Numbers: 1368260, 1402167, 1399026, 1380113, 1418795   REF 38BF3844SP Serial Number 1416814  REF 38BF4046 Serial Numbers: 1368261, 1380114, 1402168, 1399027, 1418796, 1429744, 1449113   REF 38BF4046SP Serial Number 1416950  REF 38BF4248 Serial Numbers: 1397139, 1368262, 1381417, 1399029, 1422026, 1418797, 1433514, 1449114, 1452995   REF 38BF4248SP Serial Number 1416816  REF 38BF4450 Serial Numbers: 1380115, 1399031, 1399231, 1373711, 1366654, 1418948, 1433515, 1431187, 1449115, 1482461, 1484998  REF 38BF4450SP Serial number 1416563  REF 38BF4652 Serial Numbers: 1380116, 1395709, 1368263, 1373712, 1399233, 1427277, 1429745, 1433516, 1445264, 1449116, 1460186, 1460187, 1482463, 1481980   REF 38BF4652SP Serial Numbers: 1417403, 1417616  REF 38BF4854 Serial Numbers: 1381418, 1399234, 1373904, 1368264, 1399235, 1427278, 1431188, 1433517, 1445265, 1460189, 1460188, 1468891, 1481979, 1484999   REF 38BF5056 Serial Numbers: 1381419, 1399236, 1373905, 1368265, 1397140, 1402169, 1413708, 1427279, 1445266, 1449117, 1452997, 1468892, 1468893, 1476014, 1476013, 1482462, 1571773, 1571772, 1650637, 1650638, 1651368   REF 38BF5258 Serial Numbers: 1397141, 1399237, 1368266, 1380117, 1422025, 1431189, 1445267, 1449118, 1452996, 1468894, 1476016, 1482460, 1481456, 1571771, 1571770, 1589362, 1650639   REF 38BF5258SP Serial numbers: 1416945  REF 38BF5460 Serial Numbers: 1368267, 1380118, 1397142, 1399238, 1402170, 1429746, 1433518, 14335181454410, 14335181454409, 1452478, 1476017, 1481978, 1484997, 1651370   REF 38BF5460SP Serial Number 1416944  REF 38BF5662 Serial Numbers: 1368268, 1381420, 1399239, 1422021, 1431190, 1452994, 1484996   REF 38BF5662SP Serial Number 1416957  REF 38BF5864 Serial Numbers: 1368269, 1402171, 1380124, 1399240   REF 38BF5864SP Serial Number 1416589  REF 38BF6066 Serial Numbers: 1399241, 1402172, 1380125, 1427280   REF 38BF6066SP Serial Number 1416815  REF 38QH3644 Serial Numbers: 098450454, 098450453  REF 38QH3846 Serial Numbers: 087448320, 087448319, 028455786, 108636368, 039752495, 089843391, 1283757   REF 38QH4048 Serial Numbers: 087448317, 087448318, 078573304, 108636369, 039753686   REF 38QH4250 Serial Numbers: 087447402, 087447838, 038474921, 088573305, 019741984, 039783429   REF 38QH4452 Serial Numbers: 087446899, 087447160, 058552436, 029746761, 069832435   REF 38QH4654 Serial Numbers: 036310979, 036312725, 066322950, 087445485, 087445891, 058533122, 088584084, 029751144, 059832434, 099864589,109864590   REF 38QH4856 Serial Numbers: 036308619, 036312726, 066322951, 087443056, 087444883, 038510025, 058552900, 128691657, 039763773   REF 38QH5058 Serial Numbers: 036303438, 036310069, 066322952, 087424788, 087444884, 038515854, 088584085, 029746762, 059832436, 059832438, 1322641   REF 38QH5260 Serial Numbers: 036310978, 036312727, 087445887, 087446423, 088552437, 128688680, 059831040   REF 38QH5462 Serial Numbers: 036311691, 066322954, 087445888, 087446426, 028469801, 058552901, 128691658, 029763769, 059838299   REF 38QH5664 Serial Numbers: 087446896, 087447161, 058544859, 118691659, 029751973, 059829624   REF 38QH5666 Serial Numbers: 087447403, 087447839, 058544860, 128691660, 059830306   REF 38SC3650 Serial Numbers: 025149290, 025160237, 025174327, 075208859, 085242413, 085246262, 105249039, 016300068, 026305920, 096368471, 126385423, 027393904, 087458988, 068573306, 108602432, 029744514   REF 38SC3852 Serial Numbers: 025149144, 025170078, 025160238, 035179216, 075232801, 075242414, 085246264, 105267353, 115277853, 026301520, 026317024, 036319642, 056329110, 106333747, 027385922, 107460700, 107465345, 118703700   REF 38SC4054 Serial Numbers: 025149111, 025160239, 035179223, 075236081, 085242415, 085246267, 115276025, 016277854, 036318111, 036318361, 066320283, 097438943, 127465344, 108566756, 029753065   REF 38SC4256 Serial Numbers: 025149838, 025146436, 025179217, 035188989, 075233865, 085242416, 095257911, 105268093, 105269854, 125277855, 125283868, 036318819, 066320284, 106368472, 097460701, 097480974, 038466319, 019746760   REF 38SC4458 Serial Numbers: 025144180, 025146460, 035179222, 035188990, 075233866, 085242417, 085249038, 105269855, 115276026, 115283869, 026305908, 056320285, 106336785, 027385923, 077437212,  107460702, 107461472, 029566757   REF 38SC4660 Serial Numbers: 025142838, 025146459, 025174328, 035188992, 035179221, 075233867, 085242418, 095262956, 105269857, 016283870, 036319135, 046320286, 066341722, 106368473, 116371016, 037389856, 037387396, 077432335, 107465343, 108492001, 019745503   REF 38SC4862 Serial Numbers: 025144201, 025140464, 025190407, 025170075, 025170076, 075233868, 085242419, 105262954, 105269861, 016283871, 036319136, 066320287, 087459243, 108605237, 029745502   REF 38SC5064 Serial Numbers: 025128517, 025150758, 025160240, 025170072, 025170074, 035188993, 035190419, 085242420, 085248657, 105263392, 105269867, 016283872, 066320288, 077438092, 068493738, 108605238   REF 38SC5266 Serial numbers: 025190387, 025128518, 025160241, 035179218, 035188994, 035192254, 085242421, 085248658, 105269869, 036319137, 027389086, 087438091, 107465342   REF 38SC5468 Serial Numbers: 025190390, 025128519, 025160242, 025174329, 025187586, 035190750, 075188995, 075192255, 085242394, 095248659, 105274072, 106331324, 077436606, 018495671   REF 38SC5670 Serial Numbers: 025179948, 025190082, 025179949, 025128520, 025155250, 025160243, 035179219, 085242422, 085248660, 105269872, 116331326, 107460703   REF 38SC5672 Serial Numbers: 025190391, 025190397, 025190398, 025155817, 025158548, 025160244, 035188996, 035179220, 075204364, 085242423, 095248661, 026302015, 027394748, 107460704, 028486699    
Recalling Firm/
Manufacturer
MicroPort Orthopedics Inc.
5677 Airline Rd
Arlington TN 38002-9501
For Additional Information Contact Rachael Wise
901-867-4771
Manufacturer Reason
for Recall
Revision rate trends from within the MicroPort Orthopedics Inc. database evaluated for the modular head Metal on Metal THA systems show an increasing overall trend from 2009 to present and it was found that there was a specific hazard/harm for suspected tissue reaction to metal debris over one percent for modular head CONSERVE(R) systems and DYNASTY(R) metal acetabular liner systems.
FDA Determined
Cause 2
Device Design
Action MicroPort sent an Urgent Field Safety Notice dated June 22, 2016, to all affected customers notifying them of the change in the instructions for use on July 7th, 2016 by email. The firm also notified US hospitals where the implantation surgeries occurred within the last twelve (12) months by letter on July 13th, 2016 delivered by FedEx Priority. Customers were asked to complete and return the enclosed form even if they do not have any affected product to return by fax to 1-901-451-6032 or PostMarket@ortho.microport.com. For questions regarding this recall call 901-867-4771.
Quantity in Commerce 68,221 units
Distribution Worldwide Distribution - US (nationwide) Argentina, Australia, Austria, Belgium, Brazil, Bulgaria, Canada, China, Columbia, Cyprus, Czech Republic, Denmark, Finland, France, Georgia, Germany, Greece, Iran, Italy, Jamaica, Japan, Lithuania, Malaysia, Philippines, Poland, Portugal, Russia, Slovenia, South Africa, South Korea, Spain, Switzerland, Taiwan, Netherlands, Turkey, Arab Emirates, United Kingdom, and Vietnam.
Total Product Life Cycle TPLC Device Report

1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
3 For details about termination of a recall see Code of Federal Regulations (CFR) Title 21 §7.55.
510(K) Database 510(K)s with Product Code = LZO and Original Applicant = WRIGHT MEDICAL TECHNOLOGY, INC.
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