MAUDE Adverse Event Report: SMITH & NEPHEW ORTHOPAEDICS AG TRIAL FEMORAL HEAD 32 L/+8; PROSTHESIS, HIP, SEMI-CONSTRAIND, MET/CERAM/POLY, CEMNTD OR NON-POROUS, UNCEMENT

Model Number	75100852
Medical Device Problem Code	Deformation Due to Compressive Stress (2889)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	11/25/2020
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
(b)(4).
Event or Problem Description
It was reported that three trial femoral head 32 l/+8 were found broken.It is not known if all events are related to the same procedure.No injuries or surgical delays reported.
Additional Manufacturer Narrative
It was reported that three trial femoral head 32 l/+8 (b)(4) were found broken.It is not known if all events are related to the same procedure.No injuries or surgical delays were reported.The devices, intended for use in treatment, were not returned for investigation.No product was returned for investigation and no batch number was communicated.The reported failure can therefore not be evaluated.Based on the available information, a thorough investigation cannot be conducted and the root cause of the reported issue remains undetermined.No further actions have been initiated.If the reported devices or additional information become available, this investigation will be reopened.Smith and nephew will continue to monitor the device for similar issues.This investigation is considered closed.
Additional Manufacturer Narrative
Upon receipt of additional information it has been determined that this report is a duplication of mdr 9613369-2020-00267 and should therefore be disregarded.

• Brand Name: TRIAL FEMORAL HEAD 32 L/+8
• Common Device Name: PROSTHESIS, HIP, SEMI-CONSTRAIND, MET/CERAM/POLY, CEMNTD OR NON-POROUS, UNCEMENT
• Manufacturer (Section D): SMITH & NEPHEW ORTHOPAEDICS AG; schachenallee 29; aarau CH-50 00; SZ CH-5000
• MDR Report Key: 11061085
• Report Number: 9613369-2020-00269
• Device Sequence Number: 2636427
• Product Code: LZO
• UDI-Device Identifier: 07611996121858
• UDI-Public: 07611996121858
• Combination Product (Y/N): N
• Initial Reporter Country: UK
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: company representative,foreig
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 03/19/2021

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
• Operator of Device: Health Professional
• Device Model Number: 75100852
• Device Catalogue Number: 75100852
• Device Lot Number: UNKNOWN
• Was Device Available for Evaluation?: No
• Initial Date Received by Manufacturer: 11/26/2020
• Supplement Date Received by Manufacturer: 12/24/2020; 03/16/2021
• Initial Report FDA Received Date: 12/22/2020
• Supplement Report FDA Received Date: 01/17/2021; 03/19/2021
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1