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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH DELTA V-40 CERAMIC HEAD 32/0; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER, CEMENTED OR NON-POROUS

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STRYKER ORTHOPAEDICS-MAHWAH DELTA V-40 CERAMIC HEAD 32/0; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER, CEMENTED OR NON-POROUS Back to Search Results
Catalog Number 6570-0-132
Device Problem Device Operates Differently Than Expected (2913)
Patient Problem No Consequences Or Impact To Patient (2199)
Event Date 02/19/2018
Event Type  malfunction  
Manufacturer Narrative
Review of the device history records indicate devices were manufactured and accepted into final stock with no relevant reported discrepancies.There have been no other similar events for the lot referenced.A supplemental report will be submitted upon completion of the investigation.
 
Event Description
It was reported that in performing a primary hip (side not reported) procedure, the 32mm +0 head would not lock onto the accolade ii stem.The head was able to be manually removed by the surgeon.Another head was immediately available and locked onto the stem with no issues.Rep reported that no case time was lost (no surgical delay).
 
Manufacturer Narrative
An event regarding a size/fit issue involving a ceramic head was reported.The event was not confirmed.Dimensional inspection: a dimensional inspection was performed on the returned device where all dimensions were found to be within specification.Functional inspection: not performed as the exact failure mode could not be replicated.Material analysis: not performed as the reported event is not related to material integrity of the device.Medical records received and evaluation: a medical review was not performed because no medical information was provided.Device history review: review indicated all devices were manufactured and accepted into final stock with no reported discrepancies.Complaint history review: review indicated there have been no other similar events for the reported lot.Conclusions: the event could not be confirmed nor the root cause determined because insufficient information was provided.Further information such as operative reports are needed to investigate this event further.If additional information becomes available, this investigation will be reopened.
 
Event Description
It was reported that in performing a primary hip (side not reported) procedure, the 32mm +0 head would not lock onto the accolade ii stem.The head was able to be manually removed by the surgeon.Another head was immediately available and locked onto the stem with no issues.Rep reported that no case time was lost (no surgical delay).
 
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Brand Name
DELTA V-40 CERAMIC HEAD 32/0
Type of Device
PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER, CEMENTED OR NON-POROUS
Manufacturer (Section D)
STRYKER ORTHOPAEDICS-MAHWAH
325 corporate drive
mahwah NJ 07430
MDR Report Key7342834
MDR Text Key102536805
Report Number0002249697-2018-00764
Device Sequence Number1
Product Code LZO
UDI-Device Identifier04546540608505
UDI-Public04546540608505
Combination Product (y/n)N
PMA/PMN Number
K052718
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional,other
Type of Report Initial,Followup
Report Date 08/03/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date11/30/2022
Device Catalogue Number6570-0-132
Device Lot Number62189001
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/27/2018
Initial Date Manufacturer Received 02/19/2018
Initial Date FDA Received03/15/2018
Supplement Dates Manufacturer Received07/09/2018
Supplement Dates FDA Received08/03/2018
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient Outcome(s) Other;
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