Model Number 130738203 |
Device Problem
Device Dislodged or Dislocated (2923)
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Patient Problems
Unspecified Infection (1930); Inflammation (1932); Joint Dislocation (2374); Joint Laxity (4526)
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Event Date 08/10/2022 |
Event Type
Injury
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Manufacturer Narrative
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Product complaint # (b)(4).Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, 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 medwatch, a follow-up medwatch will be filed as appropriate.
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Event Description
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Patient with rheumatoid arthritis presented with anterior dislocation of reverse shoulder replacement which required revision to hemi arthroplasty with a cta head, this was done by removing the glenoid implants and the poly cup and converting with a 52 x 26 cta head.Index procedure was at wellington public hospital also on 21 march 2019.I was unable to obtain details of the implants which remained insitu.Also couldn¿t obtain serial numbers for the screws.Reason for revision was described as instability, however he hasn¿t ruled out infection as well, awaiting results of specimens which were obtained intra op.Doi: (b)(6) 2019.Dor: (b)(6) 2022.Affected side: unknown shoulder.
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Event Description
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Additional information received indicated that there was no delay reported.
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Manufacturer Narrative
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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.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.
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Manufacturer Narrative
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Product complaint # (b)(4).Investigation summary : the device associated with this complaint was not returned.Photo evidence provided was reviewed and found no device issue visible.The reported condition was not confirmed.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 search of the depuy nonconformance (nc) quality system found no nc¿s associated with this product 130738203/lot 5333178 combination.Based on the inability to find any nc¿s against the provided product code 130738203/lot code 5333178 combination, it is reasonable to conclude that there are no anomalies with regard to manufacturing or inspection contained in the device history records that would contribute to the reported event.
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Search Alerts/Recalls
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