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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ENCORE MEDICAL L.P. TURON SHOULDER; TURON PRIMARY HUMERAL STEM, SZ 12

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ENCORE MEDICAL L.P. TURON SHOULDER; TURON PRIMARY HUMERAL STEM, SZ 12 Back to Search Results
Model Number 520-46-020
Device Problem Unexpected Therapeutic Results (1631)
Patient Problem Failure of Implant (1924)
Event Date 10/11/2019
Event Type  Injury  
Manufacturer Narrative
The reason for this revision surgery was reported as failure of hemi-arthroplasty.The previous surgery and the surgery detailed in this event occurred 4 years and 5 months apart.The healthcare professional indicated there was no delay in surgery and another suitable device was available for use.The revision surgery was completed as intended.The devices were disposed of at hospital and not made available to djo surgical for examination.A review of the device history records (dhr) show that the reported components used in the previous surgery, when released for use, met design and manufacturing requirements.There were no non-conforming material reports (ncmr) associated with the products that may have contributed to the reported event.The devices were verified to have gone through an acceptable sterilization process and were within its expiration dates at the time of the previous surgery.Customer complaint history of the reported devices showed no present trends or on-going issues that are needing a review.The root cause of this complaint was a revision surgery due to failure of hemi-arthroplasty.There were no findings during this evaluation that indicate the reported devices were defective.No information was submitted with the complaint regarding pre-existing conditions of the patient or any activities the patient was involved in that may have contributed to the event.There are multiple factors that may contribute to an event that are outside the control of djo surgical such as poor bone density, patient bone deterioration, inadequate soft tissue support, excessive range of motion, prolonged overhead activities, patient activities or trauma.There are no indications of a product or process issue affecting implant safety or effectiveness.
 
Event Description
Revision surgery - patient had a cemented hemi-arthroplasty that failed and surgeon revised him to a reverse.
 
Manufacturer Narrative
Corrected data see d2, d4 d11, g5, h4.
 
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Brand Name
TURON SHOULDER
Type of Device
TURON PRIMARY HUMERAL STEM, SZ 12
Manufacturer (Section D)
ENCORE MEDICAL L.P.
9800 metric blvd
austin, tx 78758-5445
MDR Report Key9285995
MDR Text Key166008306
Report Number1644408-2019-01123
Device Sequence Number1
Product Code KWS
UDI-Device Identifier00888912145152
UDI-Public(01)00888912145152
Combination Product (y/n)N
PMA/PMN Number
K080402
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Type of Report Initial,Followup
Report Date 12/06/2019
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 Expiration Date07/28/2020
Device Model Number520-46-020
Device Catalogue Number520-01-012
Device Lot Number456G1123
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 10/11/2019
Initial Date FDA Received11/06/2019
Supplement Dates Manufacturer Received11/06/2019
Supplement Dates FDA Received12/06/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Treatment
520-00-000 LOT 878C1339.; 520-00-000, LOT 878C1339.; 520-01-012 LOT 456G1123.; 520-46-020, LOT 919C1009.
Patient Outcome(s) Required Intervention;
Patient Age63 YR
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