BIOSTOP G CEM RESTR 16MM 546316000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2015-11-02 for BIOSTOP G CEM RESTR 16MM 546316000 manufactured by Depuy Orthopaedics Inc Us.

Event Text Entries

[30107046] This complaint is still under investigation. Depuy will notify the fda of the results of this investigation once it has been completed. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[30107047] New etq record created in order to update etq (legal system) complaint number (b)(4). Reason for original complaint: litigation papers allege the patient was revised due to implant failure. Update rec'd 4/21/15- amended litigation papers received. Original litigation indicated that the patient was implanted with asr; however, amended litigation alleges that the patient was implanted with pinnacle. The products have been updated and follow-ups created. In addition to what was previously reported, litigation alleges the patient suffers from damage to her hip joints and body. Litigation identified that this complaint is for the right hip. Update 10/9/15 medical records received. After review of the medical records the patient had a poly/metal construct, not metal/metal. All implants are now being reported, as they cannot be excluded as the cause of pain. No revision operative note has been provided. Litigation papers allege the patient had pain and a lump and that "the top of implant needs replaced". At the time of this review there was no mention of lumps or need for revision in the medical documents provided. The complaint was updated on:10/30/2015.
Patient Sequence No: 1, Text Type: D, B5


[31499616] Examination of the reported devices was not possible as they were not returned. A search of the complaints databases identified one other report against the femoral head and no other reports against the remaining product/product lot code combinations. The investigation can draw no conclusions with the information made available. Based on previous investigations this complication of joint replacement is unlikely to have been the result of a device failing to meet required specifications. 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. Corrective action was not indicated. Depuy considers the investigation closed at this time. Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1818910-2015-34251
MDR Report Key5195138
Report SourceCONSUMER
Date Received2015-11-02
Date of Report2015-10-09
Date Mfgr Received2015-11-02
Device Manufacturer Date2009-04-16
Date Added to Maude2015-11-02
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationATTORNEY
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactCHAD GIBSON
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 46581
Manufacturer CountryUS
Manufacturer Postal46581
Manufacturer Phone5743725905
Manufacturer G1DEPUY CMW 9610921
Manufacturer StreetCORNFORD RD
Manufacturer CityBLACKPOOL, LANCASHIRE FY4 4QQ
Manufacturer CountryUK
Manufacturer Postal CodeFY4 4QQ
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBIOSTOP G CEM RESTR 16MM
Generic NameCEMENT / CEMENT ACCESSORY
Product CodeJDK
Date Received2015-11-02
Catalog Number546316000
Lot Number08E1302
Device Expiration Date2011-07-31
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDEPUY ORTHOPAEDICS INC US
Manufacturer Address700 ORTHOPAEDIC DRIVE WARSAW IN 465810988 US 465810988


Patients

Patient NumberTreatmentOutcomeDate
101. Other; 2. Required No Informationntervention 2015-11-02

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