MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH DELTA V-40 CERAMIC HEAD 36/+5; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER, CEMENTED OR NON-POROUS

Model Number	6570-0-236
Medical Device Problem Codes	Unstable (1667); Insufficient Device Problem Information (3190)
Health Effect - Clinical Codes	Anemia (1706); Pain (1994); Depression (2361); Ambulation or Postural Difficulties (2544); Joint Laxity (4526)
Date of Event	12/13/2013
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
Reported event: an event regarding pain involving a ceramic head was reported.The event was not confirmed.Method & results: product evaluation and results: material analysis, visual, functional and dimensional inspections could not be performed as the device remained implanted clinician review: a review of the provided medical records by a clinical consultant stated the following comment: based upon the information given to me and the supporting documentation i cannot confirm that this event did occur.As to the root cause of the event, this cannot be determined since i cannot discern any adverse impact on the patient related to the episode of care.X-rays and office notes would be helpful in this regard.Product history review: review of the device history records indicate 40 devices were manufactured and accepted into final stock on 10 may 2013 with no relevant reported discrepancies.Complaint history review: there have been no other similar events for the lot referenced.Conclusions: the exact cause of the event could not be determined because insufficient information was provided.Further information such as return of the device, pathology reports, pre- and post-operative x-rays as well as patient history and follow-up notes are needed to complete the investigation for determining root cause.No further investigation for this event is possible at this time.If devices and / or additional information become available to indicate further evaluation is warranted, this record will be reopened.
Event or Problem Description
2014 right hip replacement with stryker.2017 left hip replacement with stryker.Update: as per patient, she had a right tha done (b)(6) 2013 about four months after surgery she couldn't walk during pt, she started to experience pain, has no balance.Patient has to use a walker.Patient would like to know if her implants are part of a recall.Patient is seeking assistance with revision surgery.
Additional Manufacturer Narrative
Reported event: an event regarding instability involving a ceramic head was reported.The event was not confirmed.Method & results: product evaluation and results: material analysis, visual, functional and dimensional inspections could not be performed as the device remained implanted.Clinician review: a review of the provided medical records by a clinical consultant indicated: based upon the information given to me and the supporting documentation i cannot confirm that this event did occur.As to the root cause of the event, this cannot be determined since i cannot discern any adverse impact on the patient related to the episode of care.X-rays and office notes would be helpful in this regard.Taking into consideration all of the material subsequently submitted, it does not change my previously stated opinion.The most important information not provided are patient¿s postoperative office notes by dr.And postoperative x-rays taken with proper positioning.It is well-known that patients who have been given an increased offset following total hip replacement can experience symptoms consistent with lateral hip pain and trochanteric bursitis.I am not saying that this has happened in this case, but further documentation, notes and x-rays would be needed in order to make a final appraisal.Product history review: review of the device history records indicate devices were manufactured and accepted into final stock with no relevant reported discrepancies.Complaint history review: there have been no other similar events for the lot referenced.Conclusions: the exact cause of the event could not be determined because insufficient information was provided.Further information such as return of the device, pathology reports as well as patient history and follow-up notes are needed to complete the investigation for determining root cause.No further investigation for this event is possible at this time.If devices and / or additional information become available to indicate further evaluation is warranted, this record will be reopened.
Event or Problem Description
2014 right hip replacement with stryker.2017 left hip replacement with stryker.Update: as per patient, she had a right tha done (b)(6) 2013 about four months after surgery she couldn't walk during pt, she started to experience pain, has no balance.Patient has to use a walker.Patient would like to know if her implants are part of a recall.Patient is seeking assistance with revision surgery.

• Brand Name: DELTA V-40 CERAMIC HEAD 36/+5
• Common Device Name: 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 Key: 11378367
• Report Number: 0002249697-2021-00348
• Device Sequence Number: 3785909
• Product Code: LZO
• UDI-Device Identifier: 04546540608543
• UDI-Public: 04546540608543
• Combination Product (Y/N): N
• Initial Reporter State: FL
• Initial Reporter Country: US
• PMA/510(K) Number: K052718
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2013
• Reporter Type: Manufacturer
• Report Source: consumer,other
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 04/16/2021

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
• Operator of Device: Health Professional
• Device Expiration Date: 05/31/2018
• Device Model Number: 6570-0-236
• Device Catalogue Number: 6570-0-236
• Device Lot Number: 43902203
• Was Device Available for Evaluation?: No
• Initial Date Received by Manufacturer: 01/29/2021
• Supplement Date Received by Manufacturer: 03/23/2021
• Initial Report FDA Received Date: 02/25/2021
• Supplement Report FDA Received Date: 04/16/2021
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Other
• Patient Age: 70 YR
• Patient Weight: 82