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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY ORTHOPAEDICS INC US PINN SECTOR W/GRIPTION 50MM; PINNACLE HIP SYSTEM : HIP METAL ACETABULAR CUPS

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DEPUY ORTHOPAEDICS INC US PINN SECTOR W/GRIPTION 50MM; PINNACLE HIP SYSTEM : HIP METAL ACETABULAR CUPS Back to Search Results
Model Number 1217-32-050
Device Problems Device Dislodged or Dislocated (2923); Noise, Audible (3273)
Patient Problems Fall (1848); Fatigue (1849); Fever (1858); Unspecified Infection (1930); Pain (1994); Ambulation Difficulties (2544); Swelling/ Edema (4577)
Event Date 08/25/2021
Event Type  Injury  
Manufacturer Narrative
Product complaint # (b)(4).If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
 
Event Description
Litigation and medical records received ad 11 may 2022.It was reported the patient had a right total hip arthroplasty, to address right hip degenerative joint disease.Depuy components were used during this procedure.Doi: (b)(6) 2018; dor: (b)(6) 2021; right hip.
 
Manufacturer Narrative
Product complaint # (b)(4).Investigation summary: no device associated with this report was received for examination.The information received will be retained for potential series investigations if triggered by trend analysis, post market surveillance, or other events within the quality system.Depuy considers the investigation closed.Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary.Device history lot: a manufacturing record evaluation (mre), was not possible because the required lot code was not provided.H10 additional narrative: e3 initial reporter occupation: lawyer.
 
Event Description
On (b)(6) 2018 the patient had a right total hip arthroplasty, to address right hip degenerative joint disease.Depuy components were used during this procedure.Physical therapy notes report that on (b)(6) 2018, patient admitted to hospital x3 days related to fatigue, mild confusion, elevated wbc¿s, place don iv antibiotics.Recurring fevers and leukocytosis, hip effusion, right, the patient had a ct aspiration of right hip to address right hip effusion *on (b)(6) 2018, the patient reports having falling on wet floor, pain and difficulty walking.On (b)(6) 2021 the patient underwent a revision, anterior right total hip replacement to address failed right total hip replacement, disengagement of polyethylene liner, spin out.The indications for surgery including pain and squeaking of the right hip.During the procedure the surgeon reported finding a fractured disengaged polyethylene liner, well-fixed acetabular component, well-fixed femoral component.The surgeon reported that there was no obvious insufficiency of the locking mechanisms, however, ¿this could be microscopic¿.The femoral head had a wear stripe from articulation against the acetabular component.The cup, liner, head, and 1 screw were removed.Depuy components were implanted in this procedure.
 
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Brand Name
PINN SECTOR W/GRIPTION 50MM
Type of Device
PINNACLE HIP SYSTEM : HIP METAL ACETABULAR CUPS
Manufacturer (Section D)
DEPUY ORTHOPAEDICS INC US
700 orthopaedic drive
warsaw IN 46581 0988
Manufacturer (Section G)
DEPUY ORTHOPAEDICS, INC. 1818910
700 orthopaedic dr.
warsaw IN 46581 0988
Manufacturer Contact
kate karberg
700 orthopaedic dr.
warsaw, IN 46581-0988
3035526892
MDR Report Key14590615
MDR Text Key293252689
Report Number1818910-2022-10012
Device Sequence Number1
Product Code JDI
UDI-Device Identifier10603295010296
UDI-Public10603295010296
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K093646
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 06/01/2022
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 Model Number1217-32-050
Device Catalogue Number121732050
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 05/11/2022
Initial Date FDA Received06/03/2022
Supplement Dates Manufacturer Received07/05/2022
Supplement Dates FDA Received07/06/2022
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 Initial
Patient Sequence Number1
Treatment
ALTRX +4 NEUT 32IDX50OD; CORAIL AMT COLLAR SIZE 10; DELTA CER HEAD 12/14 32MM +1; PINN CAN BONE SCREW 6.5MMX20MM
Patient Outcome(s) Required Intervention;
Patient Age43 YR
Patient SexFemale
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