TRINITY 322.03.636 NOT APPLICABLE

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2019-12-17 for TRINITY 322.03.636 NOT APPLICABLE manufactured by Corin Medical.

Event Text Entries

[172574135] Per 2622 initial report. In order to progress with the investigation of this event, operative notes, patient details and an update on the patient following revision has been requested, however, this information is not available and thus the investigation of this event is limited. A post primary x-ray has been provided and will be reviewed at corin. It has been confirmed that the explants will not be returned for examination. The appropriate device details have been provided and the relevant device manufacturing 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 occurred outside of the usa.
Patient Sequence No: 1, Text Type: N, H10


[172574138] Trinity revision of the cup, head and liner after approximately 4 months due to dislocation.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9614209-2019-00132
MDR Report Key9481412
Report SourceCOMPANY REPRESENTATIVE
Date Received2019-12-17
Date of Report2020-03-06
Date of Event2019-11-25
Date Mfgr Received2019-11-26
Device Manufacturer Date2019-07-17
Date Added to Maude2019-12-17
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR FRANCK DIDIER
Manufacturer StreetTHE CORINIUM CENTRE CIRENCESTER
Manufacturer CityGLOUCESTERSHIRE, GL7 1YJ
Manufacturer CountryUK
Manufacturer PostalGL7 1YJ
Manufacturer G1CORIN MEDICAL
Manufacturer StreetTHE CORINIUM CENTRE CIRENCESTER
Manufacturer CityGLOUCESTERSHIRE, GL7 1YJ
Manufacturer CountryUK
Manufacturer Postal CodeGL7 1YJ
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameTRINITY
Generic NameACETABULAR HIP SYSTEM WITH ECIMA LINERS
Product CodeMEH
Date Received2019-12-17
Model Number322.03.636
Catalog NumberNOT APPLICABLE
Lot Number426510
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerCORIN MEDICAL
Manufacturer AddressTHE CORINIUM CENTRE CIRENCESTER GLOUCESTERSHIRE, GL7 1YJ UK GL7 1YJ


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization; 2. Required No Informationntervention 2019-12-17

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