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DePuy ASR Hip Recall Guide and Metallosis Risk

Over 90,000 US citizens are recipients of the recalled DePuy ASR DePuy hip implant. We think only a fraction of individuals with an ASR DePuy hip implant have been identified, because they do not…

Over 90,000 US citizens are recipients of the recalled DePuy ASR  DePuy hip implant. We think only a fraction of individuals with an ASR  DePuy hip implant have been identified, because they do not want to go  through the tough surgical ordeal again. Our goal is that we want to get  all recipients of the recalled ASR DePuy hip implant identified, so  that they get meaningful legal and medical help.

The ASR DePuy implants were widely used throughout the United States  from 2005, until 2010. We are recommending every recipient, or family  member of a recalled ASR DePuy hip implant to call us, if they are  suffering pain, problems walking, swelling of the hip, or lack of  flexibility. It has already been well documented that there is an  extremely high failure rate for the ASR DePuy hip implants.

Women are reporting more problems, and a higher failure rate, with  the DePuy ASR XL Acetabular hip replacement system. Women are also more  likely to develop some of the serious side effects of the defectively  designed implant, including metallosis.

Metallosis is a build-up of cobalt and chromium ions in the soft  tissue of the body, particularly around the joints. Metallosis has been  noted in people with all kinds of metal-on-metal joint implants and  replacement systems. The engineering of the implant is causing far more  friction, which leads to metallic debris being released into the tissue  surrounding the implant.

The design of the ASR XL Acetabular system was developed to provide a  greater range of motion. The DePuy engineers removed the plastic liner  from the inside of the hip implant and made the acetabular cup shallow  so that patients could move their legs in a wider arc.

The femoral head moves constantly back and forth as the hip implant’s  owner moves normally, and that puts stress on the acetabular cup. In an  implant with a deeper acetabular cup than the DePuy ASR hip implant,  there is more material to accommodate the strain of motion. The force is  distributed over a bigger surface, which means that the implant overall  can hold up to that strain better.

The already-shallow hip implant is made smaller overall to  accommodate a woman’s smaller frame. Women have naturally wider hips and  larger hip sockets than men do, which means that the shallow acetabular  cup becomes in effect even shallower.

And the smaller the surface area of the implant, the more likely the  material will break down rapidly releasing metal ions into the body.  Those metal ions accumulate in the soft tissues surrounding the hip  joint, causing metallosis.

Women also more likely to see the problems that develop as a result  of metallosis, including metal hypersensitivity, heavy metal poisoning  (which includes chromium poisoning and cobalt poisoning) and tissue and  bone deterioration.

We are DePuy ASR and DePuy Pinnacle recall attorneys and are providing this news update to the victims of Defective DePuy ASR Hips and DePuy Pinnacle Hips.

According to allegations raised in a new DePuy Pinnacle hip lawsuit  filed earlier this month, the manufacturer of the implant has known for  some time that it was a defective and dangerous device, and should have  removed it from the market years ago.

The complaint was filed in The U.S. District Court for the District  of New Jersey against DePuy Orthopaedics, Inc., Johnson & Johnson  and the designer of the metal-on-metal hip replacement.

The DePuy Pinnacle hip system was introduced in 2001, with some  variations containing a metal liner instead of a polyethylene liner,  which can result in microscopic metal particles being shed into the body  as the metal parts of the hip replacement rub against each other. This  can lead to inflammation, swelling, loosening of the parts and  ultimately may cause the hip replacement to fail, resulting in the need  for hip revision surgery.

The companies did issue a recall for the DePuy ASR hip replacement  system in August 2010, due to problems that are similar to what has been  reported in connection with the Pinnacle hip. The DePuy ASR was  approved by the FDA in 2005 as a “substantially equivalent” design to  the DePuy Pinnacle. Post-marketing data provided at the time of that  recall indicated that the DePuy ASR failure rate was about 12-13%, but  some estimates suggest that nearly 50% of the recalled ASR hip  replacements may lead to failure problems within six years.

In October 2010, the American Academy of Orthopaedic Surgeons (AAOS)  issued a warning about potential problems with metal on-metal hip  replacements, indicating that patients and the medical community should  be aware that pain months after hip replacement surgery may be a sign of  metal-on-metal hip cobalt toxicity. The FDA launched a new website in February to provide information about the risks associated with metal-on-metal hip replacements.

The metal ions, usually cobalt or chromium, can damage bone and  tissue around the implant and joint, causing the implant to become loose  or causing the patient to feel pain. The particles can have effects on  the heart, nervous system and thyroid when in the bloodstream at high  levels.

In the U.K., health officials recommend patients with metal-on-metal  hip implants that are causing them pain be tested for metal ions in the  blood, but the FDA has yet to make similar recommendations.  Metal-on-metal hip implant recipients should see their orthopedic  surgeon if they experience symptoms including heart pain, chest pain,  shortness of breath, numbness, weakness, changes in vision or hearing,  fatigue, unexplained cold, weight gain or changes in urination habits,  the FDA advises.

A California lawsuit has been filed with the U.S. Judicial Panel on  Multidistrict Litigation to consolidate and centralize the federal DePuy  Pinnacle hip litigation in one court for coordinated pretrial  proceedings, either as part of the pending DePuy ASR recall litigation  or as a new multidistrict litigation (MDL).  The DePuy ASR hip recall  litigation is already consolidated as part of an MDL, in the U.S.  District Court for the Northern District of Ohio.

The lawsuit argues that they are all related on common issues of  fact, and such consolidation helps reduce duplicative discovery in  different cases, eliminates inconsistent rulings from different judges  and serves the convenience of the parties, lawyers and the courts. The  plaintiff has requested that the Panel either designate a new court for  handling of the litigation over DePuy Pinnacle hips or consolidate the  DePuy ASR lawsuits and DePuy Pinnacle lawsuits in the same coordinated  action.

While approximately 93,000 DePuy ASR hip systems were sold before it  was removed from the market, more than 150,000 DePuy Pinnacle hips were  manufactured according to the lawsuit. In addition, since the August  2010 ASR recall, more than 1,300 people have filed an adverse event  report with the FDA involving problems with a DePuy Pinnacle hip.

Shezad Malik MD JD

Shezad Malik MD JD

Shezad Malik is an Internal Medicine and Cardiology specialist, a Texas Medical Doctor (retired) and Defective Medical Device and Dangerous Drug Attorney.

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