Model Number 130738209 |
Device Problems
Device Dislodged or Dislocated (2923); Naturally Worn (2988)
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Patient Problems
Joint Dislocation (2374); Insufficient Information (4580)
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Event Date 04/06/2023 |
Event Type
Injury
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Manufacturer Narrative
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Product complaint # : (b)(4).Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
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Event Description
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It was reported that this was a rtsa for rotator cuff tear osteoarthrosis of left shoulder performed on (b)(6) 2022.On (b)(6) 2023, the patient fell off and the implant dislodged.Therefore, a revision surgery was performed.It was confirmed that the cup in question was worn out.A new similar implant was inserted, and the revision surgery was completed successfully.No further information is available.
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Manufacturer Narrative
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Product complaint # (b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by depuy synthes joint reconstruction, or its employees that the report constitutes an admission that the product, depuy synthes joint reconstruction, or its employees caused or contributed to the potential event described in this report.Added: b5, d10 and h6 (device code) if information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.H6 (clinical code).
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Event Description
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Additional information received: a.What was meant by "implant dislodged"? the implant dislocated from its original position due to the fall.B.Was there a surgery delay? if yes, what was the duration of the delay? no.
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Manufacturer Narrative
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Product complaint # (b)(4).Investigation summary : no device associated with this report was received for examination.The information received will be retained for potential series investigations if triggered by trend analysis, post market surveillance, or other events within the quality system.Depuy considers the investigation closed.Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary.Device history lot : the product investigation found no evidence suspecting an error in the manufacturing or material that would be a contributing factor in the reported allegation(s).A manufacturing records evaluation (mre) was not performed.
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Search Alerts/Recalls
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