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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITH & NEPHEW ORTHOPAEDICS LTD BHR MODULAR SLEEVE -4MM; PROSTHESIS, HIP, HEMI-, TRUNNION-BEARING, FEMORAL, METAL/POLYACETAL

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SMITH & NEPHEW ORTHOPAEDICS LTD BHR MODULAR SLEEVE -4MM; PROSTHESIS, HIP, HEMI-, TRUNNION-BEARING, FEMORAL, METAL/POLYACETAL Back to Search Results
Catalog Number 74222100
Device Problems Adverse Event Without Identified Device or Use Problem (2993); Appropriate Term/Code Not Available (3191)
Patient Problems Toxicity (2333); Test Result (2695)
Event Date 11/14/2019
Event Type  Injury  
Event Description
Revision surgery is scheduled due to increased metal ion levels.
 
Manufacturer Narrative
A custom made device was requested to replace the modular head in a revision surgery.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 bhr cup was performed using batch numbers in search of similar recurring reports for the products during their lifetimes.Similar complaints have been identified and this failure 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 the released devices involved met manufacturing specifications at the time of production.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 a result of the reported event.The available medical documents were reviewed.It was reported that the revision surgery was performed due to increased chromium levels.However, it was communicated via email that there is no consent to provide medical information.Without any supporting medical evidence, the reported event cannot be assessed and a thorough medical assessment cannot be performed.Upon receipt of medical/clinical records, the clinical task will be re-opened and assessed at that time.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
BHR MODULAR SLEEVE -4MM
Type of Device
PROSTHESIS, HIP, HEMI-, TRUNNION-BEARING, FEMORAL, METAL/POLYACETAL
Manufacturer (Section D)
SMITH & NEPHEW ORTHOPAEDICS LTD
aurora house
spa park
leamington spa CV31 3HL
UK  CV31 3HL
MDR Report Key9108551
MDR Text Key161832609
Report Number3005975929-2019-00353
Device Sequence Number1
Product Code JDH
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,foreig
Type of Report Initial,Followup
Report Date 02/20/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/24/2019
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue Number74222100
Was Device Available for Evaluation? Yes
Date Manufacturer Received09/16/2019
Patient Sequence Number1
Treatment
ACETABULAR CUP, # 74120154, LOT # 59418; FEMORAL STEM, # 71357005, LOT # UNKNOWN; MODULAR HEAD, # 74222146, LOT # UNKNOWN
Patient Outcome(s) Hospitalization; Required Intervention;
Patient Age64 YR
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