PLASMACUP SC SIZE 52MM NH052T

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-03-18 for PLASMACUP SC SIZE 52MM NH052T manufactured by Aesculap Ag.

Event Text Entries

[183944071] Manufacturing site evaluation: investigation on-going. Additional information / investigation results will be provided in a supplemental report.
Patient Sequence No: 1, Text Type: N, H10


[183944072] It was reported that there was an issue with plasmacup. According to the complaint description, the patient had a post operative fracture of the ceramic insert. The initial surgery was on (b)(6) 2009. On (b)(6) 2020 the patient consulted the surgeon, because she heard a noise which was audible from the prosthesis; she also had complaints of discomfort. An x-ray examination revealed fragments of ceramic insert in the trochanter. The surgeon stated that anteversion of the acetabular is a bit increased, but it was not a problem. A revision surgery was necessary, but not yet scheduled. Additional information was not provided nor available / was not available. The adverse event/malfunction is filed under (b)(4). ( involved component). Associated medwatch-reports: (b)(4) nh103 is not reportable, because it is not approved in the us. Associated medwatch-reports with involved components: this reporting is only with involved components. We have no leading material. (b)(4)- biolox prosthesis head 12/14 32mm m - 51481241 (9610612-2020-00052).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9610612-2020-00053
MDR Report Key9847870
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-03-18
Date of Report2020-03-18
Date of Event2020-02-14
Date Mfgr Received2020-02-18
Device Manufacturer Date2009-06-25
Date Added to Maude2020-03-18
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS KERSTIN ROTHWEILER
Manufacturer StreetPO BOX 40
Manufacturer CityTUTTLINGEN, 78501
Manufacturer CountryGM
Manufacturer Postal78501
Manufacturer G1AESCULAP AG
Manufacturer StreetPO BOX 40
Manufacturer CityTUTTLINGEN, 78501
Manufacturer CountryGM
Manufacturer Postal Code78501
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePLASMACUP SC SIZE 52MM
Generic NameHIP ENDOPROSTHETICS
Product CodeLWJ
Date Received2020-03-18
Model NumberNH052T
Catalog NumberNH052T
Lot Number51572087
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerAESCULAP AG
Manufacturer AddressPO BOX 40 TUTTLINGEN, 78501 GM 78501


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-03-18

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