MAUDE Adverse Event Report: CORIN LTD TRINITY; ACETBULAR SYSTEM WITH HXLPE LINERS

Model Number	104.3605
Medical Device Problem Codes	Adverse Event Without Identified Device or Use Problem (2993); Insufficient Device Problem Information (3190)
Health Effect - Clinical Code	Joint Dislocation (2374)
Date of Event	08/18/2025
Type of Reportable Event	Serious Injury
Event or Problem Description
Trinity revision of the ecima liner and biolox delta ceramic head after 4 months and 18 days due to dislocation from a subsided paragon stem.
Additional Manufacturer Narrative
(b)(4) initial report.The following additional information was requested from the reporter: post primary and pre revision x-rays.Operative notes (primary and revision).Patient activity level and medical history.Did the patient follow correct post-op protocol? what was the patient doing at the time of the dislocation? did the patient experience any trips / falls or other trauma post primary surgery? what was implanted at the revisions? an update on the patient post revision.The appropriate device details have been provided, and the relevant device manufacturing and sterilisation records will be identified and reviewed.Please note: this report is filed with the fda due to an adverse event experienced with a device that is similar to those placed on the market in the usa.However, this event occured outside the usa.The submission of this report does not constitute an admission that the device reporting entities representative or distributor caused or contributed to this event.
Additional Manufacturer Narrative
Per-(b)(4) final report.The following additional information was requested from the reporter: - post primary and pre revision x-rays - operative notes (primary and revision) - patient activity level and medical history - did the patient follow correct post-op protocol? - what was the patient doing at the time of the dislocation? - did the patient experience any trips / falls or other trauma post primary surgery? - what was implanted at the revisions? - an update on the patient post revision.This information was not provided and thus the scope of the investigation was limited.The appropriate device details were provided and the relevant device manufacturing records have been identified and reviewed.All parts associated with these records conformed to material and dimensional specification at the time of manufacture.Based on the available information, no further investigation can be conducted and the root cause of the reported dislocation could not be determined.Therefore, this case is now considered closed, however, should any additional information be provided then this case may be re-opened for further investigation.Please note: this report is filed with the fda due to an adverse event experienced with a device that is similar to those placed on the market in the usa.However, this event occured outside the usa.The submission of this report does not constitute an admission that the device reporting entities representative or distributor caused or contributed to this event.
Event or Problem Description
Trinity revision of the ecima liner and biolox delta ceramic head after 4 months and 18 days due to dislocation from a subsided paragon stem.

• Brand Name: TRINITY
• Common Device Name: ACETBULAR SYSTEM WITH HXLPE LINERS
• Manufacturer (Section D): CORIN LTD; the corinium centre; cirencester, gloucestershire GL7 1 YJ; UK GL7 1YJ
• Manufacturer (Section G): CORIN LTD; the corinium centre; cirencester, gloucestershire GL7 1 YJ; UK GL7 1YJ
• Manufacturer Contact: franck didier ; the corinium centre; cirencester, gloucestershire GL7 1-YJ ; UK GL7 1YJ
• MDR Report Key: 22911727
• Report Number: 9614209-2025-00569
• Device Sequence Number: 9047953
• Product Code: LZO
• UDI-Device Identifier: 05055196964389
• UDI-Public: 05055196964389
• Combination Product (Y/N): N
• Initial Reporter Country: AS
• PMA/510(K) Number: K110087
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2025
• Device Explanted Year: 2025
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 10/30/2025

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 Model Number: 104.3605
• Device Catalogue Number: N/A
• Device Lot Number: 586333
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 08/18/2025
• Supplement Date Received by Manufacturer: 08/18/2025
• Initial Report FDA Received Date: 08/28/2025
• Supplement Report FDA Received Date: 10/30/2025
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 01/30/2025
• 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
• Patient Sequence Number: 1
• Concomitant Medical Products and Therapy/Usage Dates: TRINITY ECIMA LINER: 322.03.636, (B)(6).; TRINITY ECIMA LINER: 322.03.636, (B)(6).
• Outcome Attributed to Adverse Event: Hospitalization; Required Intervention
• Patient Age: 44 YR
• Patient Sex: Female