MAUDE Adverse Event Report: DEPUY IRELAND - 9616671 UNKNOWN HIP ACETABULAR CUP

Catalog Number UNK HIP ACETABULAR CUP

Device Problem Noise, Audible (3273)

Patient Problems Foreign Body Reaction (1868); Pain (1994); Unspecified Musculoskeletal problem (4535)

Event Date 12/19/2023

Event Type  malfunction  

Event Description

It was reported that patient underwent revision of hip pe-inlays.Additional event information: patient was lifting heavy cement bags and had pain and squeaking in left hip.Xrays show hip head is off center and suspect dislocation.During the revision, osteophytes along the ¿socket edge¿ were identified along with metallosis, a head/liner dislocation and fractured inlay.Doi: (b)(6) 2023.Dor: (b)(6) 2023.

Manufacturer Narrative

Product complaint (b)(4).D4: the device catalog number is unknown; therefore, udi is unavailable.Investigation summary: according to the information received, "hcp reported two consecutive revisions of hip pe-inlays.This complaint is about the second revision".¿the product was not returned to depuy synthes, however x-rays were provided for review.See attachments ((b)(4) x-rays and (b)(4) x-rays).The x-ray investigation revealed that the dlt ts cer hd 12/14 32mm +9 was not properly centered at implant site.This type of condition may happen due to a dissociation between altrx neut 32idx48od and unknown hip acetabular cup, confirming a possible audible sound.Surgical technique pinnacle ® hip solutions pages 11-12 indicate that "the targeted shell abduction (as measured on radiographs) should be 40-45 degrees taking into account local soft tissue and anatomic landmarks", and "the targeted shell anteversion (as measured on radiographs) should be 15-20 degrees taking into account local soft tissue and anatomic landmarks".Abduction angle of 53 degrees, showed on evidence, confirms a dissociation on liner and cup/shell, suggesting a future fracture or dislocation.However, since quality of x-rays reviewed are poor, no observations pertaining to the nature of the reported event could be identified.Therefore, neither allegation could be confirmed.Since the device was not returned, a dimensional inspection cannot be performed.The overall complaint was confirmed as the observed condition of the unknown hip acetabular cup would contribute to the complained device issue.Based on the investigation findings, it has been determined that no corrective and/or preventative action is proposed.There is no indication that a design or manufacturing issue has caused the complaint condition.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.Device history lot : a manufacturing records evaluation (mre) was not performed as no lot number was provided for this device.If the lot/serial number becomes available, the record will be re-assessed.This report is being submitted pursuant to the provisions of 21 cfr, part 803 (and/or part 4, as applicable).This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by depuy synthes, or its employees that the report constitutes an admission that the product, depuy synthes, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.

Manufacturer Narrative

Product complaint # (b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by depuy synthes joint reconstruction, or its employees that the report constitutes an admission that the product, depuy synthes joint reconstruction, or its employees caused or contributed to the potential event described in this report.H10 additional narrative: added: d10.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.

• Brand Name: UNKNOWN HIP ACETABULAR CUP
• Type of Device: HIP ACETABULAR CUP
• Manufacturer (Section D): DEPUY IRELAND - 9616671; loughbeg ringaskiddy co.; cork ; EI
• Manufacturer (Section G): JTE WARSAW MFG SITE; 700 orthopaedic drive; warsaw IN
• Manufacturer Contact: kate karberg ; 700 orthopaedic dr.; warsaw, IN 46581-0988 ; 3035526892
• MDR Report Key: 19204542
• MDR Text Key: 341439568
• Report Number: 1818910-2024-09398
• Device Sequence Number: 1
• Product Code: LPH
• Combination Product (y/n): N
• Reporter Country Code: GM
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Foreign,Health Professional,Company Representative
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial
• Report Date: 04/29/2024

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 04/29/2024
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: UNK HIP ACETABULAR CUP
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Date Manufacturer Received: 04/25/2024
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Unknown
• Patient Sequence Number: 1
• Treatment: ALTRX +4 10D 32IDX48OD; UNKNOWN HIP ACETABULAR CUP