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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH 22.2MM STD LFIT V40 HEAD; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, CEMENTED

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STRYKER ORTHOPAEDICS-MAHWAH 22.2MM STD LFIT V40 HEAD; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, CEMENTED Back to Search Results
Catalog Number 6260-9-122
Device Problem Degraded (1153)
Patient Problems Foreign Body Reaction (1868); Unspecified Infection (1930); Pain (1994); Inadequate Osseointegration (2646); Metal Related Pathology (4530)
Event Date 06/18/2020
Event Type  Injury  
Manufacturer Narrative
An event regarding abnormal ion level, wear and infection involving an metal head was reported.The event was not confirmed.Method & results: -product evaluation and results: material analysis, visual, functional and dimensional inspections could not be performed as the device was not returned.-clinician review: no medical records were received for review with a clinical consultant.-product history review: review of the device history records indicate devices were manufactured and accepted into final stock with no relevant reported discrepancies.-complaint history review: there have been no other similar events for the lot and sterile lot referenced.Conclusions: all stryker products sold as sterile are validated to a minimum sterility assurance level sal of 10^-6 in accordance with applicable iso standards.The exact cause of the event could not be determined because insufficient information was provided.Further information such as pathology reports and the revision operative report as well as patient history and follow-up notes are needed to complete the investigation for determining root cause.No further investigation for this event is possible at this time.If devices and/or additional information become available to indicate further evaluation is warranted, this record will be reopened.The following devices were also listed in this report: cat# 1236-2-244; restoration adm x3 ins; lot# 333493 cat# 626-00-38d; modular dual mobility insert; lot# 56571501 cat# 542-11-48d; trident psl with purefix ha 48mm; lot# 57353004 cat# 2060-0000-1; acetabular dome hole plug; lot# ml1emp cat# 2030-6530-1; 6.5 cancellous bone screw 30mm; lot# 903etw cat# 2030-6525-1; 6.5 cancellous bone screw 25mm; lot# 1e1j8nr.It cannot be determined which, if any of these devices may have caused or contributed to the patient's experience.
 
Event Description
It was reported through the filing of a lawsuit that allegedly the patient underwent left total hip arthroplasty on (b)(6) 2017.It is alleged that she began experiencing severe hip pain, burning pain when sitting and sleeping, along with clicking in the left hip.Radiographs showed aseptic loosening of the left femoral component.Workups completed revealed elevated metal levels (esr 38, crp 19, cobalt and chromium <1.0) and a left hip aspiration showed the growth of staph hominis.Allegedly as metallosis was suspected, she underwent a left total hip revision on (b)(6) 2020.
 
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Brand Name
22.2MM STD LFIT V40 HEAD
Type of Device
PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, CEMENTED
Manufacturer (Section D)
STRYKER ORTHOPAEDICS-MAHWAH
325 corporate drive
mahwah NJ 07430
Manufacturer (Section G)
STRYKER ORTHOPAEDICS-CORK
ida industrial estate
carrigtwohill NA
EI   NA
Manufacturer Contact
joann ripoli
325 corporate drive
mahwah, NJ 07430
2018315000
MDR Report Key18683764
MDR Text Key335069404
Report Number0002249697-2024-00214
Device Sequence Number1
Product Code JDI
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K121308
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Consumer
Reporter Occupation Other
Type of Report Initial
Report Date 02/12/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/12/2024
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Expiration Date10/31/2021
Device Catalogue Number6260-9-122
Device Lot Number57171305
Was Device Available for Evaluation? No
Date Manufacturer Received01/17/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured10/12/2016
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention; Hospitalization;
Patient SexFemale
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