MAUDE Adverse Event Report: SMITH & NEPHEW ORTHOPAEDICS LTD ACETLR CUP HAP 56MM W/ IMPTR; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/METAL, RESURFACING

Model Number 74120156

Device Problems Degraded (1153); Biocompatibility (2886)

Patient Problems Cyst(s) (1800); Failure of Implant (1924); Arthralgia (2355); Metal Related Pathology (4530)

Event Date 08/02/2021

Event Type  Injury  

Manufacturer Narrative

Internal complaint reference: (b)(4).

Event Description

It was reported that, after a bhr resurfacing construct had been implanted on the patient¿s left hip on (b)(6) 2010, the patient experienced extensive metallosis, joint pain, large anterior fluid cyst and damage to antero-superior region of the acetabular implant.A revision surgery was performed on (b)(6) 2021 to treat this adverse event.During this procedure, an extensive metallosis staining of the soft tissue around the hip was visualized and carefully debrided.The bhr resurfacing head was removed upon performing a femoral neck cut.The acetabular cup presented an anterior superior wear and a defect in the surface of the cup, making it necessary to revise this component as well.The hip was converted into a full thr system.The patient was transferred to the recovery room in stable condition.

Manufacturer Narrative

H3, h6: it was reported that a let hip revision surgery was performed.As of today, the implanted devices, all of which were used in treatment have not been returned for evaluation.A review of the historical complaints data for the acetabular cup and femoral head was performed using batch numbers to evaluate patterns of repeated failures or defects over the lifetime of the product and using part numbers and the reported failure modes to evaluate patterns of repeated failures or defects in a timeframe prior 12 months as of the complaint aware date no other similar complaints were identified to involve this batch.Other similar complaints were identified for the part number and the reported failure mode.This will continue to be monitored.In the absence of the actual devices, the production records were reviewed for the devices reportedly involved in this incident.All released devices involved met manufacturing specifications upon release for distribution.Review of the product ifu found adequate warnings and precautions in relation to the alleged failure modes.A risk management review was performed.The alleged failure modes and associated risks have been anticipated within the risk file and the anticipated risk level is still adequate.A review of historic escalation actions related to the products and similar complaint events was performed.Following the review, prior applicable escalation actions were identified and confirmed to reduce associated risks as far as possible.No further escalation actions required.The available medical documents were reviewed.Based on the reported symptoms it cannot be concluded that the events/clinical reactions (pain, extensive metallosis, fluid collection, and damage to the acetabular cup) were associated with a mal-performance of the implant.The patient impact cannot be determined at this time.Based on the available information we can confirm the reported complaint, however without further information our investigation remains inconclusive, and a definitive root cause cannot be determined.Specific factors known to contribute to the alleged fault are excessive physical activity levels, unreasonable stress on replacement system, excessive patient weight, trauma to the joint replacement, loosening of components may increase production of wear particles and accelerate damage to the bone.Should the devices or additional information be received, the complaint will be reopened.Based on this investigation, the need for corrective and preventative actions is not indicated.

Event Description

It was reported that, after a bhr resurfacing construct had been implanted on the patient¿s left hip on (b)(6) 2010, the patient experienced extensive metallosis, joint pain, large anterior fluid cyst and damage to antero-superior region of the acetabular implant.A revision surgery was performed on (b)(6) 2021 to treat this adverse event.During this procedure, an extensive metallosis staining of the soft tissue around the hip was visualized and carefully debrided.The acetabular cup presented an anterior superior wear and a defect in the surface of the cup, making it necessary to revise this component.The hip was converted into a full thr system.The patient was transferred to the recovery room in stable condition.

• Brand Name: ACETLR CUP HAP 56MM W/ IMPTR
• Type of Device: PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/METAL, RESURFACING
• Manufacturer (Section D): SMITH & NEPHEW ORTHOPAEDICS LTD; aurora house, spa park; leamington spa warwickshire CV31 3HL; UK CV31 3HL
• Manufacturer (Section G): SMITH & NEPHEW ORTHOPAEDICS LTD; aurora house, spa park; leamington spa warwickshire CV31 3HL; UK CV31 3HL
• Manufacturer Contact: holly topping ; 7000 west william cannon drive; austin, TX 78735 ; 5123913905
• MDR Report Key: 14527516
• MDR Text Key: 293301459
• Report Number: 3005975929-2022-00354
• Device Sequence Number: 1
• Product Code: NXT
• UDI-Device Identifier: 03596010502599
• UDI-Public: 03596010502599
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: P040033
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Health Professional,User Facility,Company Representative
• Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date: 08/07/2022

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Expiration Date: 07/30/2015
• Device Model Number: 74120156
• Device Catalogue Number: 74120156
• Device Lot Number: 10GW28980
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 05/05/2022
• Initial Date FDA Received: 05/27/2022
• Supplement Dates Manufacturer Received: 08/01/2022
• Supplement Dates FDA Received: 08/07/2022
• Date Device Manufactured: 07/31/2010
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention; Other; Hospitalization
• Patient Age: 64 YR
• Patient Sex: Female