inforMED
MalfunctionMAY

MCREYNOLDS IMPACTOR ADAPTER

Received May 3, 2016 · Event occurred Apr 7, 2016

Report 0002249697-2016-01499 · MDR key 5629039

Device

Generic name

Prosthesis, Hip, Semi-constrained, Metal/ceramic/polymer, Cemented Or Non-porous

Catalog number

6260-4-090

Lot number

TDEN403

Product problems

  • Break

Patient

69 YR

  • No Known Impact Or Consequence To Patient
  • No Known Impact Or Consequence To Patient

Narrative

Additional Manufacturer Narrative

A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem

THREADS ON THE MCREYNOLDS DISTAL STEM ADAPTER BROKE OFF IN THE CONICAL DISTAL STEM AS SURGEON WAS ATTEMPTING TO REMOVE THE STEM FROM THE CANAL.

Additional Manufacturer Narrative

REPORTED EVENT: AN EVENT REGARDING FRACTURE INVOLVING A MCREYNOLDS ADAPTOR WAS REPORTED. THE EVENT WAS CONFIRMED. METHOD & RESULTS: DEVICE EVALUATION AND RESULTS: EXAMINATION OF THE DEVICE CONFIRMED THE EVENT AND DETERMINED THE DEVICE FRACTURED IN OVERLOAD. MEDICAL RECORDS RECEIVED AND EVALUATION: NOT PERFORMED AS NO MEDICAL RECORDS WERE RECEIVED. DEVICE HISTORY REVIEW: THERE WERE NO REPORTED DISCREPANCIES. COMPLAINT HISTORY REVIEW: THERE HAVE BEEN NO OTHER EVENTS FOR THE REFERENCED LOT. CONCLUSIONS: THE INVESTIGATION CONCLUDED THAT THE EXAMINATION OF THE DEVICE INDICATED THE THREADS FRACTURED DUE TO OVERLOAD. IF ADDITIONAL INFORMATION BECOMES AVAILABLE, THIS INVESTIGATION WILL BE REOPENED. PRODUCT SURVEILLANCE WILL CONTINUE TO MONITOR FOR TRENDS.

Description of Event or Problem

THREADS ON THE MCREYNOLDS DISTAL STEM ADAPTER BROKE OFF IN THE CONICAL DISTAL STEM AS SURGEON WAS ATTEMPTING TO REMOVE THE STEM FROM THE CANAL.