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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY ORTHOPAEDICS INC US UNKNOWN SHOULDER GLENOSPHERE; SHOULDER HUMERAL HEADS

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DEPUY ORTHOPAEDICS INC US UNKNOWN SHOULDER GLENOSPHERE; SHOULDER HUMERAL HEADS Back to Search Results
Catalog Number UNK SHOULDER GLENOSPHERE
Device Problem Device Dislodged or Dislocated (2923)
Patient Problems Neurological Deficit/Dysfunction (1982); Joint Dislocation (2374); No Code Available (3191)
Event Type  Injury  
Manufacturer Narrative
Product complaint # (b)(4).Investigation summary: no device associated with this report was received for examination.Depuy synthes considers the investigation closed at this time.Should additional information be received, the information will be reviewed and the investigation may be re-opened as necessary.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.9 patients involved.
 
Event Description
Update 14-jan-2018: "reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly" was read for mdr reportability.After review of the article for mdr reportability, the article indicates a delta reverse shoulder was implanted in 43 patients between january 2000 to january 2005.No patient identifies were provided for the 43 patients.Of the 43 patients the following patient harms and product deficiencies were noted.Five patients experienced neurological complications which mostly resolved.Three patients experienced reflex sympathetic dystrophy which resolved.One patient experienced a non-traumatic dislocation 6 weeks after implantation.
 
Manufacturer Narrative
Product complaint # (b)(4).Investigation summary
=
> no device associated with this report was received for examination.Depuy synthes considers the investigation closed at this time.Should additional information be received, the information will be reviewed and the investigation may be re-opened as necessary.If information is obtained that was not available for the initial medwatch, a follow-up medwatch, a follow-up medwatch will be filed as appropriate.
 
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Brand Name
UNKNOWN SHOULDER GLENOSPHERE
Type of Device
SHOULDER HUMERAL HEADS
Manufacturer (Section D)
DEPUY ORTHOPAEDICS INC US
700 orthopaedic drive
warsaw IN 46581 0988
Manufacturer (Section G)
JTE WARSAW MFG SITE
700 orthopaedic drive
warsaw IN
Manufacturer Contact
kara ditty-bovard
700 orthopaedic dr.
warsaw, IN 46581-0988
6107428552
MDR Report Key8264658
MDR Text Key133693581
Report Number1818910-2019-81633
Device Sequence Number1
Product Code KWS
Combination Product (y/n)N
Reporter Country CodeFR
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type foreign,literature
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 01/14/2019
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? No
Device Operator Health Professional
Device Catalogue NumberUNK SHOULDER GLENOSPHERE
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 01/14/2019
Initial Date FDA Received01/21/2019
Supplement Dates Manufacturer Received01/23/2020
Supplement Dates FDA Received01/28/2020
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
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