PINN CAN BONE SCREW 6.5MMX25MM
Received Jul 20, 2020 · Event occurred Jul 9, 2020
Report 1818910-2020-16314 · MDR key 10300028
Device
Generic name
Bone Screws And Pins : Screws
Manufacturer
Depuy Orthopaedics Inc UsModel number
1217-25-500Catalog number
121725500
Lot number
D17040473
Product problems
- Adverse Event Without Identified Device or Use Problem
- Adverse Event Without Identified Device or Use Problem
Patient
57 YR
- Adhesion(s)
- Pain
- No Code Available
- Adhesion(s)
- Pain
- No Code Available
Narrative
Additional Manufacturer Narrative
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. H10 ADDITIONAL NARRATIVE: CORRECTED: D11. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE.
Additional Manufacturer Narrative
(B)(4). IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.
Description of Event or Problem
IT WAS REPORTED THAT THE PATIENT PRESENTS WITH GROIN PAIN. SURGEON BELIEVES CUP COULD BE LOOSE. HEAD IS REMOVED, FOLLOWED BY LINER, SCREW AND HOLE ELIMINATOR. CUP INSERTION HANDLE IS ATTACHED TO SHELL AND FOUND TO BE WELL FIXED AND APPROPRIATE ORIENTATION. RANGE OF MOTION DID SHOW SOME IMPINGEMENT WITH INTERNAL ROTATION. TRIAL REDUCTION WAS MOST STABLE WITH A +4/10 DEGREE LINER AND ONE LONGER BALL. SCAR TISSUE WAS REMOVED FROM WHERE THE IMPINGEMENT WAS TAKING PLACE. DOI: (B)(6) 2017; DOR: (B)(6) 2020; RIGHT HIP.
Additional Manufacturer Narrative
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.