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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITH & NEPHEW ORTHOPAEDICS LTD ACETLR CUP HAP 60MM W/ IMPTR; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/METAL, RESURFACING

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SMITH & NEPHEW ORTHOPAEDICS LTD ACETLR CUP HAP 60MM W/ IMPTR; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/METAL, RESURFACING Back to Search Results
Model Number 74120160
Device Problems Adverse Event Without Identified Device or Use Problem (2993); Appropriate Term/Code Not Available (3191)
Patient Problems Unspecified Infection (1930); Pain (1994); Swelling (2091); Injury (2348)
Event Date 11/01/2013
Event Type  Injury  
Event Description
It was reported that a two stage bhr revision was performed due to deep infection, pain, aval and pseudotumor.Cup exchanged.
 
Manufacturer Narrative
It was reported that two stage hip revision surgery was performed.During this revision, the acetabular cup and stem were removed.As of today, the implanted devices, all of which were used in treatment, and additional information have been requested for this complaint but have not become available.A review of the complaint history for the stem was performed using batch numbers in search of similar recurring reports for the products during their lifetimes.Similar complaints have been identified, however, these complaints are from the same patient / device.In the absence of the actual devices, the production records were reviewed for the devices reportedly involved in this incident.All the released devices involved met manufacturing specifications at the time of production.Sterilization records were reviewed for the stem which confirmed that all devices were sterilized.Review of the product ifu found adequate warnings and precautions in relation to the alleged failure modes.A risk management review was performed.No additional risks were identified as result of the reported event.No further actions are required at this time.No medical documents have been made available for review, therefore no thorough medical investigation can be performed.Without return of the actual devices or further information we cannot further investigate or confirm the details supplied in this complaint, and our investigation remains inconclusive.If the products or additional information become available in the future, this case will be reopened.No preventative or corrective action has been initiated as a result of this investigation.
 
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Brand Name
ACETLR CUP HAP 60MM 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 CV31 3HL
UK  CV31 3HL
MDR Report Key9756341
MDR Text Key181101661
Report Number3005975929-2020-00074
Device Sequence Number1
Product Code NXT
UDI-Device Identifier03596010502612
UDI-Public03596010502612
Combination Product (y/n)N
PMA/PMN Number
P040033
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,consum
Type of Report Initial,Followup
Report Date 05/08/2020
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? No
Device Operator No Information
Device Model Number74120160
Device Catalogue Number74120160
Initial Date Manufacturer Received 02/13/2020
Initial Date FDA Received02/26/2020
Supplement Dates Manufacturer Received05/07/2020
Supplement Dates FDA Received05/08/2020
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Treatment
ANTHOLOGY STEM 71357010/ 6AM12601A.
Patient Outcome(s) Hospitalization; Required Intervention;
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