inforMED
InjuryNDJ

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

Model number

1217-25-500

Catalog 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.