MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH V40 COCR LFIT HEAD 36MM/-5; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, CEMENTED

Catalog Number	6260-9-036
Medical Device Problem Codes	Degraded (1153); Detachment of Device or Device Component (2907)
Health Effect - Clinical Codes	Ambulation or Postural Difficulties (2544); Joint Laxity (4526)
Date of Event	05/17/2023
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
An evaluation of the device cannot be performed as the device was not returned to the manufacturer.Should additional information become available it will be reported in a supplemental report upon completion of the investigation.
Event or Problem Description
On (b)(6) 2008 implantation of a stryker hip prosthesis with trident screw acetabular cup, pe inlay, accolade stem, metal head.In the course now increasing instability with multiple falls.On (b)(6) 2023 evidence of premature material wear.V.A implant fracture, revision surgery on (b)(6) 2023 with massive metallosis and evidence of complete wear of the metal femoral neck.
Event or Problem Description
On (b)(6) 2008 implantation of a stryker hip prosthesis with trident screw acetabular cup, pe inlay, accolade stem, metal head.In the course now increasing instability with multiple falls.On (b)(6) 2023 evidence of premature material wear.V.A implant fracture, revision surgery on (b)(6) 2023 with massive metallosis and evidence of complete wear of the metal femoral neck.
Additional Manufacturer Narrative
An event regarding wear and disassociation involving a lfit v40 cocr head that was mated with an accolade stem was reported.The event was confirmed.Method & results: -product evaluation and results: visual inspection: the reported device was not returned however photographs were provided for review.The photographs show a recently explanted head with body fluids on it.It seemed to be removed still seated onto the trunnion of the stem.However, once removed from the stem in a second photo, there is evidence of wear of the trunnion, black tissue and the taper of the head appears dark in colour.Material analysis, functional, and dimensional inspections could not be performed as the device was not returned.-clinician review: a review of the provided medical records by a clinical consultant indicated: 'this case concerns a patient who underwent a primary cementless total hip arthroplasty in 2008 and then approximately 18 years later developed head neck disassociation with metallosis requiring revision surgery.I can confirm that the patient underwent a primary total hip replacement and sustained a head neck disassociation since i was able to review x-rays showing the implants.I cannot confirm the revision surgery since i have no documentation such as office notes, operation note or post revision x-rays.The root causes of had neck disassociation with metallosis are multifactorial including surgical technique factors, trunnion and head preparation prior to implantation, patient factors such as activity level and bmi, and implant factors.The explanted femoral prosthesis and femoral head should be submitted to stryker engineers for examination and evaluation.' -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 has been one other similar event for the lot referenced for wear.Conclusions: the reported device was not returned however photographs were provided for review.The photographs show a recently explanted head with body fluids on it.It seemed to be removed still seated onto the trunnion of the stem.However, once removed from the stem in a second photo, there is evidence of wear of the trunnion, black tissue and the taper of the head appears dark in colour.The subject device has been identified to be within scope of nc and capa.Lot specific voluntary recall was initiated for the lfit v40 cocr heads within scope of a capa.The investigation revealed that only specific catalog numbers and specific lots are impacted by the regulatory action and that the affected lots were manufactured on or before march 4, 2011.The root cause analysis identified a process related anomaly as to the affected sizes and lots.The affected product has all been implanted and/or expired.

• Brand Name: V40 COCR LFIT HEAD 36MM/-5
• Common Device Name: PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, CEMENTED
• Manufacturer (Section D): STRYKER ORTHOPAEDICS-MAHWAH; 325 corporate drive; mahwah NJ 07430
• Manufacturer (Section G): STRYKER ORTHOPAEDICS-MAHWAH; 325 corporate drive; mahwah NJ 07430
• Manufacturer Contact: joann ripoli ; 325 corporate drive; mahwah, NJ 07430 ; 2018315000
• MDR Report Key: 17306632
• Report Number: 0002249697-2023-00767
• Device Sequence Number: 20504389
• Product Code: JDI
• UDI-Device Identifier: 07613327032291
• UDI-Public: 07613327032291
• Combination Product (Y/N): N
• Initial Reporter Country: GM
• PMA/510(K) Number: K022077
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2008
• Device Explanted Year: 2023
• Reporter Type: Manufacturer
• Report Source: Other
• Initial Reporter Occupation: Other
• Remedial Action: Recall
• Type of Report: Initial,Followup
• Report Date (Section B): 09/07/2023

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: 05/31/2013
• Device Catalogue Number: 6260-9-036
• Device Lot Number: WL1MHE
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 06/16/2023
• Supplement Date Received by Manufacturer: 08/18/2023
• Initial Report FDA Received Date: 07/12/2023
• Supplement Report FDA Received Date: 09/07/2023
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 05/27/2008
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• If action reported to FDA under 21 USC 360i(g), list FDA-assigned Recall Number or include a statement: 2249697-05/07/2018-003R
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Hospitalization; Required Intervention
• Patient Age: 86 YR
• Patient Sex: Female
• Patient Weight: 65 KG