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Company Recalls Faulty Devices Inside Patients' Bodies
by John McKenzie

ABCNEWS.com

Jan. 17 — When you think of "recalls," you tend to think of cars, or tires, or appliances. But what happens when it's a medical device that's been surgically implanted inside your body? Last month, the Sulzer Orthopedics company announced the recall of a hip-replacement part that's been put inside more than 17,000 patients.

Three months ago, Lindsay Low received an artificial hip. Today, it is virtually useless. Putting weight on it causes the hip to buckle — and Low to fall.

"I can only walk little short distances with my crutches," explains Low. "Right now I'm in a wheelchair. The pain is very severe, such that if I were to walk I would worry."

Low's natural hip bone is not growing into the new, artificial socket. Her doctor explains, while pointing to her X-ray, "The gap indicates the cup is loose and with the cup being loose, that means it's painful."

Last month, doctors discovered why. They got a letter from the Sulzer Orthopedics announcing a defect in the hip socket Low and thousands of other patients had received.

The company said that a production error had left traces of machine oil on the artificial joints and that the recall would begin immediately.

"We have accepted full responsibility for this," Steven Whitlock of Sulzer Orthopedics told ABCNEWS. "We're profoundly disturbed by the effect the recall has had on the surgeon as well as the patient. And we're sorry for that."

"I was frustrated. Part of me was angry," says Low. "Recalls are supposed to be for tires or something. They're really not supposed to be recalling things inside people."

What Happens Now?

At Summit Hospital in San Francisco, doctors have identified 254 patients who received the recalled hip.

"Surgeons are not going to remove every one of the recalled hips," says Summit's Dr. Mac Reynolds. "Patients not experiencing pain will simply be X-rayed every three months. Those who do have pain, we recommend replacing the implant."

No one knows how many of these operations will be needed — or how difficult they might be.

Replacing an artificial hip can take twice as long in the operating room as putting one in. That's because there's usually much more scar tissue. And then there are all the risks from another surgery: the potential for blood loss, and infection, and complications.

Low is scheduled to have her replacement operation later this month.

"I've got to have this thing out," says Low. "I've got to have a new one put in. And I've got to go through all the rehab again."

The company has offered to cover medical costs not paid by Medicare or other health insurance, but some patients are filing lawsuits for lost wages and what they see as unnecessary pain and suffering.

Read the Sulzer Press Release
The company put out the following press release on the recall:

Sulzer Medica to Voluntarily Recall Inter-Op™ Hip Shells

Sulzer Medica announced today that its subsidiary, Sulzer Orthopedics has voluntarily recalled certain manufacturing lots of its Inter-Op acetabular shells for hip implants sold primarily in the United States after October 1999, with a small number of lots sold after July 1997. During recent exhaustive testing of its Inter-Op manufacturing process, a very low percentage of acetabular components evidenced a slight residue of a lubricant on the exterior porous surface of the shell. Our specialists and independent scientists consulting with Sulzer Orthopedics have concluded that this residue may cause reactions in vivo potentially leading to aseptic loosening of the shell.

Since mid-September 2000 Sulzer Orthopedics has received reports of post-operative loosening of a number of the Inter-Op acetabular shells. According to an extensive investigation, these random cases appear to be related to a reaction of the body to a slight residue of a lubricant used in the manufacturing process. Based on a random sampling of affected product lots, a small number of products evidenced a higher than expected level of this residue. Approximately 17,500 products from the affected lots have been implanted, approximately 90% of them in the US. From October 1999 to date, 61 cases of loosening, or less than 0.5% of the total number of implanted shells have been reported.

Sulzer Orthopedics has notified the implanting surgeons, the Food and Drug Administration and other regulatory agencies and implemented changes to its manufacturing process to address the cause of the problem. There is no indication that any of the other products manufactured by Sulzer Orthopedics or any other subsidiary of Sulzer Medica are affected by this phenomenon.

The new bearing surfaces introduced by Sulzer Orthopedics in the US in recent months, Metasul and Durasul, are in no way related to the Inter-Op recall. The Inter-Op shell was introduced to the market in 1996 and except for this incidence, has demonstrated excellent clinical results.

Sulzer Medica does not expect a material financial effect as a result of the voluntary recall.

Gary Sabins, President of Sulzer Orthopedics, said: "Sulzer Orthopedics deeply regrets any effect this may have on patients who have received a shell covered by this recall. Only a very small number of patients who have received one of these shells may require medical intervention other than standard post-operative monitoring. Sulzer Orthopedics is not recommending prophylactic removal of the affected product. In the best interest of our patients and surgeons, we have chosen to err on the side of caution with this strictly voluntary action. Based on exhaustive testing, we have identified the problem and implemented and validated improvements in the manufacturing process to ensure production of the highest quality parts possible."

Headquartered in Winterthur, Switzerland, Sulzer Medica develops, manufactures and markets implantable medical devices and biological products for cardiovascular and orthopedic markets worldwide. The Company's product offering includes joint prostheses, spinal implants, dental implants, trauma surgery products, heart valves, and vascular grafts (Swiss Stock Exchange: SMEN; NYSE: SM).

The SAFE HABOR STATEMENT UNDER THE PRIVATE SECURITY LITIGATION REFORM ACT OF 1995: This press release contains forward-looking statements that involve risks and uncertainties, including, but not limited to projections of future financial condition, results of operations and cash flows. These statements are subject to change based on known and unknown risks and various other factors, which could cause the actual results or performance to differ materially from the statements made herein.

For more information, please contact Sulzer at 800-888-4676, ext. 232

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